Sociodemographic Indicators of Social Position and Self-care Maintenance in Adults with Heart Failure

Baah, Foster Osei; Chittams, Jesse; Carlson, Beverly; Sethares, Kristen A.; Daus, Marguerite; Moser, Debra K.; Riegel, Bárbara

doi:10.1177/1054773821995593

Cited by 11 publications

(16 citation statements)

References 29 publications

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“…We found that self-reported race was associated with self-care maintenance, with participants of White race (compared with a group that predominantly reported being African American) reporting higher levels. These findings are consistent with a previous study in which self-identified race was associated with self-care maintenance (Baah et al, 2021) but contrasted with another study of self-care in a predominantly African American sample of men with comorbid Type II diabetes and HF (Aga et al, 2019) who had better self-care than others. These findings merit further consideration given evidence of greater risk for adverse HF outcomes and health equity concerns among underrepresented minority groups (Steinberg et al, 2021), including African Americans.…”

Section: Discussionsupporting

confidence: 91%

Sleep Characteristics, Mood, Somatic Symptoms, and Self-Care Among People With Heart Failure and Insomnia

et al. 2022

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BackgroundAlmost 50% of people with heart failure (HF) experience chronic insomnia and must perform self-care to manage their day-to-day healthcare needs. Understanding multifactorial influences on self-care, including demographic, clinical, and sleep characteristics, and mood and somatic symptoms will help identify people at highest risk for poor self-care. However, past research focused only on the associations of single symptoms and self-care. Multivariate approaches are needed to account for the synergistic associations of self-care with sleep, mood, and somatic symptoms among people with HF.ObjectivesThe aims of the study were to (a) evaluate the levels of self-care maintenance and self-care confidence among people with stable HF and chronic insomnia; (b) identify the clinical and demographic correlates of self-care maintenance and confidence among people with stable HF and chronic insomnia; and (c) identify the associations between sleep characteristics, mood and somatic symptoms, and self-care maintenance and confidence among people with stable HF and chronic insomnia.MethodsWe utilized a cross-sectional design with 195 adult participants who had chronic HF and insomnia. We assessed for symptoms of anxiety; depression; dyspnea; fatigue; stress; insomnia severity; and sleep disturbance, impairment, and quality. Self-care was measured using the Self-Care for Heart Failure Index v6.2. We used generalized linear models to test the associations between the demographic and clinical factors and self-care maintenance and confidence; exploratory and confirmatory factor analysis to identify the factor structure underlying the symptoms; and structural equation modeling to test the combined associations of the demographic and clinical factors and latent factors with self-care maintenance and confidence.ResultsSelf-care maintenance, confidence, and management were inadequate in most participants. We identified three latent factors among the nine symptoms: “sleep characteristics,” “mood,” and “somatic symptoms.” In the structural equation model, “sleep characteristics,” White race, and having a left ventricular ejection fraction of <45 were associated with self-care maintenance. Age was negatively associated with self-care confidence.DiscussionPoor sleep characteristics negatively influence the ability of people with HF and insomnia to perform self-care behaviors. Knowledge of the associations among age, left ventricular ejection fraction, and race with self-care will help clinicians and future researchers identify those at risk for poor self-care.

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Section: Discussionsupporting

confidence: 91%

Sleep Characteristics, Mood, Somatic Symptoms, and Self-Care Among People With Heart Failure and Insomnia

et al. 2022

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“…Immigrants with higher income may find it easier to adhere to healthy dietary practices because they are unable to afford the financial costs of healthy groceries (Laaksonen et al, 2003). However, the influence of income on health behaviors is not straightforward because other socioeconomic conditions impact the health of socially marginalized persons (Baah et al, 2019, 2021; Braveman & Gottlieb, 2014; Havranek et al, 2015; Riegel et al, 2017). This characteristic cannot be modified, but screening for income inadequacy may help to identify patients at risk for poor self-care.…”

Section: Discussionmentioning

confidence: 99%

Self-Care of African Immigrant Adults with Chronic Illness

et al. 2021

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This cross-sectional study aims to describe the self-care of adult African immigrants in the US with chronic illness and explore the relationship between acculturation and self-care. A total of 88 African immigrants with chronic illness were enrolled. Self-care was measured with the Self Care of Chronic Illness Inventory v3 and the Self-Care Self-Efficacy scale. Scores are standardized 0 to 100 with scores >70 considered adequate. Acculturation was measured using a modified standardized acculturation instrument and predefined acculturation proxies. The self-care scores showed adequate self-care, with the mean scores of 78.6, 77.9, and 75.6 for self-care maintenance, monitoring, and management. Self-care self-efficacy mean score was 81.3. Acculturation was not significantly associated with self-care. Self-care self-efficacy was a strong determinant of self-care maintenance ( p < .0001), monitoring ( p < .0001), and management ( p < .0001). The perception of inadequate income was a significant determinant of poor self-care management ( p = .03). Self-care self-efficacy and perceived income adequacy were better determinants of self-care than acculturation.

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“…Moreover, being married, having some college education, and being of Asian race only marginally explained the variance in HF self-care in this study (Baah et al, 2021). To date, studies of the influence of race and gender on HF self-care have consistently yielded inconclusive results (Baah et al, 2021; Graven et al, 2021; Koirala et al, 2018). Although sociodemographic factors may have some impact on HF self-care, other personal factors may be more important in motivating self-care adherence.…”

Section: Introductionmentioning

confidence: 63%

“…In contrast, another study found no association between age, income, and HF self-care (Baah et al, 2021). Moreover, being married, having some college education, and being of Asian race only marginally explained the variance in HF self-care in this study (Baah et al, 2021). To date, studies of the influence of race and gender on HF self-care have consistently yielded inconclusive results (Baah et al, 2021; Graven et al, 2021; Koirala et al, 2018).…”

Section: Introductionmentioning

confidence: 96%

“…In one study, HF self-care adherence was inversely related to older age, low income, inadequate social support, lower educational levels, and inadequate health literacy (White-Williams et al, 2020). In contrast, another study found no association between age, income, and HF self-care (Baah et al, 2021). Moreover, being married, having some college education, and being of Asian race only marginally explained the variance in HF self-care in this study (Baah et al, 2021).…”

Section: Introductionmentioning

confidence: 96%

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The Relationships Among Health Literacy, Patient Activation, and Self-Care Behaviors in Adults With Heart Failure: A Cross Sectional Study

2023

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Despite current efforts, adherence to heart failure (HF) selfcare remains suboptimal. There is a need to identify modifiable factors that promote self-care adherence. Evidence suggests that patient activation and health literacy (HL) are modifiable and may be useful for improving HF self-care. However, more research is needed to understand the influences of these variables on HF self-care. The aim of this study was to examine the relationships between patient activation, health literacy, and self-care adherence in a diverse group of adults with HF. This study used a correlational, cross-sectional design. Correlation and regression tests were used to analyze associations among variables. Stratified random sampling was applied to attain a study sample that was 50% persons of color (POC). Of the 174 participants, 51% were female and 48.5% were POC with a mean age of 62 years. There was no significant relationship between HL and HF self-care adherence. There was a small, positive correlation between HL and dichotomized high/low activation levels ( r = .163; p < .05). There was a small, positive correlation between patient activation and HF self-care behaviors ( r = .151; p < .05). However, regression tests showed patient activation was not a predictor of selfcare ( B = 0.173, p = .064). Persons with HF may perform self-care activities when highly activated, regardless of HL status. Patient activation was not a reliable predictor of self-care adherence. More research is needed to elucidate the influence of patient activation and HL on HF self-care behaviors.

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Sociodemographic Indicators of Social Position and Self-care Maintenance in Adults with Heart Failure

Cited by 11 publications

References 29 publications

Sleep Characteristics, Mood, Somatic Symptoms, and Self-Care Among People With Heart Failure and Insomnia

Sleep Characteristics, Mood, Somatic Symptoms, and Self-Care Among People With Heart Failure and Insomnia

Self-Care of African Immigrant Adults with Chronic Illness

The Relationships Among Health Literacy, Patient Activation, and Self-Care Behaviors in Adults With Heart Failure: A Cross Sectional Study

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