Self-efficacy mediates the relationship of depressive symptoms and social support with adherence in patients with heart failure

Abstract

Poor self-care is common among adults with heart failure and leads to poor health outcomes. Low self-efficacy, depression, and low social support are associated with poor self-care, but knowledge about these relationships in heart failure is limited. Secondary data analysis of cross-sectional data from 346 adults with heart failure measuring self-efficacy, depressive symptoms, social support, and self-care adherence was conducted. Tests of mediation using multiple linear regressions indicate that self-efficacy fully mediates the relationships between depression and adherence, and social support and adherence. Bolstering self-efficacy may have a greater impact on self-care adherence than targeting either depression or social support alone.

Relationship Between Psychological Distress and Cognitive Function Differs as a Function of Obesity Status in Inpatient Heart Failure

“…Research suggests that cognitive function can improve in the HF population (Stanek et al, 2009(Stanek et al, , 2011Alosco et al, 2014a), and that self-care can improve despite cognitive dysfunction (Cameron et al, 2017). Given the relationship with morbidity, hospitalization, and mortality in HF (Yohannes et al, 2010;Sherwood et al, 2011;Kato et al, 2012;Ketterer et al, 2014;Agarwal et al, 2016;Huynh et al, 2016;Tovar et al, 2016), cognitive assessment in HF is of critical importance, particularly in those patients at high risk for readmission. This research highlights cognitive dysfunction, depression, and anxiety as critical targets in HF treatment, and further emphasizes the need to identify populations at elevated risk.…”

“…Psychological distress is quite prevalent in HF, with depression affecting up to 60% of patients (Yohannes et al, 2010) and up to 55% of patients demonstrating elevated anxiety (Easton et al, 2016). Both depression and anxiety in HF are risk factors for reduced quality of life, poor self-care, and higher rates of hospitalization and mortality (Yohannes et al, 2010;Sherwood et al, 2011;Kato et al, 2012;Ketterer et al, 2014;Suzuki et al, 2014;Alhurani et al, 2015;Tovar et al, 2016). While a growing literature demonstrates a relationship between depression and cognitive dysfunction in cardiovascular disease in general (Armstrong et al, 2018), and HF in particular (Foster et al, 2011;Garcia et al, 2011;Alosco et al, 2014a;Hawkins et al, 2015a), it is unknown how anxiety impacts cognitive function in HF.…”

Examining and adapting the information–motivation–behavioural skills model of medication adherence among community-dwelling older patients with multimorbidity: protocol for a cross-sectional study

“…A systematic review has identified that higher self-efficacy is associated with better medication adherence in hypertension 30. Also, self-efficacy has been found to play a key role in mediating the relationships between medication adherence and other variables, such as patients’ personality,31 depression32 and social support 33 34…”

Expanding the Palliative Care Domains to Meet the Needs of a Community-Based Supportive Care Model

“… 16 When applied to patients with severe heart failure, ESAS symptom scores exhibit poor correlation with validated measures of social functioning and self-efficacy, attributes that independently mediate drivers of effective self-care. 17 , 18 Studies of persons with advanced lung cancer or heart failure reveal they suffer distress from impending mortality, functional loss, and social isolation. 19 Even when emotional distress is identified, it may be a marker for suffering in other, unarticulated domains.…”