Trajectory of self-care in people with stable heart failure and insomnia after two self-care interventions

Conley, Samantha; Jeon, Sangchoon; Andrews, Laura; Breazeale, Stephen; Hwang, Youri; O’Connell, Meghan; Linsky, Sarah; Redeker, Nancy S.

doi:10.1016/j.pec.2022.09.001

Cited by 2 publications

(2 citation statements)

References 52 publications

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“…This is supported by the fact that better self‐care behaviours capability of patients with HF leads to better clinical outcomes including readmissions rates (Liljeroos et al, 2020; Toukhsati et al, 2019; Zhang, Koirala, et al, 2022). At present, self‐care behaviours are viewed as the individual responsibility of patients, who are accordingly expected to exhibit changes in health behaviours to manage their disease (Conley et al, 2022). Therefore, in order to promote self‐care behaviours including medication adherence and symptom management, it is necessary for nurses to provide tailored education and appropriate motivation to patients.…”

Section: Discussionmentioning

confidence: 99%

“…However, in spite of its significance, the self‐care behaviours of patients with HF remain suboptimal (Boyde et al, 2018; Pobrotyn et al, 2021). Recent studies have highlighted the presence of varying, heterogeneous trajectories of self‐care behaviours in patients with HF (Conley et al, 2022; Liljeroos et al, 2020; Pancani et al, 2018). However, studies of the relationship between long‐term trajectories of self‐care behaviours and hospital readmissions among HF patients are limited.…”

Section: Introductionmentioning

confidence: 99%

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One‐year trajectories of self‐care behaviours and unplanned hospital readmissions among patients with heart failure: A prospective longitudinal study

Son

Jang

2023

Journal of Clinical Nursing

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Aim and ObjectivesThis study aimed to identify the associations between longitudinal trajectories of self‐care behaviours and unplanned hospital readmissions in patients with heart failure.BackgroundAdherence to self‐care behaviours is crucial to prevent hospital readmissions; however, self‐care behaviours remain unsatisfactory among patients with heart failure. Studies of long‐term trajectories of self‐care behaviours and their influence on hospital readmissions are limited in this population.DesignA prospective, longitudinal observational study.MethodsAmong 137 participants with heart failure (mean age 67.36 years, 62% men), we analysed the 1‐year follow‐up data to determine the association between 1‐year trajectories of self‐care behaviours and hospital readmissions using Kaplan–Meier analysis and multivariable Cox regression, adjusted for confounding variables.ResultsSelf‐care behaviour trajectories of heart failure patients were classified as ‘high‐stable’ (58.4%) or ‘low‐sustained’ (41.6%). The cumulative rate of readmissions for the low‐sustained class was higher than that of the high‐stable class for all periods. Factors influencing readmissions included anaemia, cognitive function, frailty and self‐care behaviours trajectories. The low‐sustained class had a 2.77 times higher risk of readmissions within 1 year than that in the high‐stable class.ConclusionsLongitudinal self‐care behaviours pattern trajectories of heart failure patients were stratified as high‐stable and low‐sustained. Routine follow‐up assessment of patients' self‐care behavioural patterns, including anaemia and frailty, and cognitive function can minimise unplanned hospital readmissions.Relevance to clinical practiceIdentification of trajectory patterns of self‐care behaviours over time and provision of timely and individualised care can reduce readmissions for heart failure patients. Healthcare professionals should recognise the significance of developing tailored strategies incorporating longitudinal self‐care behavioural patterns in heart failure patients.Reporting MethodThe study has been reported in accordance with the STROBE checklist (Appendix S1).Patient or Public ContributionPatients have completed a self‐reported questionnaire after providing informed consent.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

One‐year trajectories of self‐care behaviours and unplanned hospital readmissions among patients with heart failure: A prospective longitudinal study

Son

Jang

2023

Journal of Clinical Nursing

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Self-care trajectories of patients with coronary heart disease: a longitudinal, observational study

Ingadóttir,

Svavarsdóttir,

Jurgens

et al. 2024

European Journal of Cardiovascular Nursing

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Aims To determine if distinct trajectories of coronary heart disease (CHD) self-care behaviours could be identified, linked to differences in quality of life (QoL), and predicted based on baseline characteristics. Methods and results A secondary analysis of a prospective, longitudinal, observational study. Patients with CHD answered questionnaires at study enrolment and six months later: Self-Care of Coronary Heart Disease Inventory (three subscales: maintenance, management and confidence, scored 0-100, higher score = better self-care), Hospital Anxiety and Depression Scale, 12-Item Short Form Survey, 16-Item European Health Literacy Survey Questionnaire, CHD Education Questionnaire. Latent growth mixture modelling was used to identify distinct self-care trajectories over time. On average, patients (n = 430, mean age 64.3 ± 8.9, 79% male) reported inadequate self-care (maintenance 61.6 ± 15.4, management 53.5 ± 18.5) at enrolment. Two distinct trajectories of self-care behaviours were identified: First, an “inadequate-and-worsening” (IN-WORSE) trajectory (57.2%), characterised by inadequate self-care, improvement in maintenance (4.0 ± 14.5-point improvement, p < 0.001) and worsening of management over time (6.3 ± 24.4-point worsening, p = 0.005). Second, an “inadequate-but-maintaining” (IN-MAIN) trajectory (42.8%), characterised by inadequate self-care, improvement in maintenance (5.0 ± 16.2-point improvement, p < 0.001) and stability in management over time (0.8 ± 21.9-point worsening, p = 0.713). In comparison, patients in the IN-WORSE trajectory had less favourable characteristics (including lower health literacy, knowledge, confidence) and significantly lower QoL. Not attending rehabilitation (OR 2.175; CI 1.020-4.637, p = 0.044) and older age (OR 0.959; CI 0.924-0.994, p = 0.024) predicted (IN-WORSE) trajectory inclusion. Conclusion Two self-care trajectories were identified, both suboptimal. Rehabilitation predicted membership in the more favorable trajectory and some positive characteristics were identified among patients in that group. Therefore, interventions supporting these factors may benefit patients’ self-care and QoL.

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Trajectory of self-care in people with stable heart failure and insomnia after two self-care interventions

Cited by 2 publications

References 52 publications

One‐year trajectories of self‐care behaviours and unplanned hospital readmissions among patients with heart failure: A prospective longitudinal study

One‐year trajectories of self‐care behaviours and unplanned hospital readmissions among patients with heart failure: A prospective longitudinal study

Self-care trajectories of patients with coronary heart disease: a longitudinal, observational study

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