Longitudinal patterns and predictors of self-care behavior trajectories among Korean patients with heart failure: A 6-month prospective study
- Authors
- Kim, Da-Young; Son, Youn-Jung
- Issue Date
- Mar-2023
- Publisher
- WILEY
- Keywords
- cognitive function; health literacy; heart failure; longitudinal study; self-care behaviors; social support
- Citation
- JOURNAL OF NURSING SCHOLARSHIP, v.55, no.2, pp 429 - 438
- Pages
- 10
- Journal Title
- JOURNAL OF NURSING SCHOLARSHIP
- Volume
- 55
- Number
- 2
- Start Page
- 429
- End Page
- 438
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/59193
- DOI
- 10.1111/jnu.12833
- ISSN
- 1527-6546
1547-5069
- Abstract
- Purpose This study aimed to identify distinct trajectories of self-care behaviors over 6 months after hospital discharge in patients with heart failure, including the baseline predictors affecting these trajectories. Design This was a prospective longitudinal observational cohort study with a 6-month follow-up. Methods A total of 158 patients with heart failure (mean age = 66.75 years, 62.7% men) were included in this study. Patients' characteristics, including cognitive function, health literacy, and social support were collected as possible baseline predictors of self-care behavior trajectories using a structured questionnaire and an electronic medical record review. Self-care behaviors were evaluated using the Korean version of the nine-item European Heart Failure Self-care Behavior Scale at baseline, 1, 3, and 6 months after hospital discharge. Latent growth model analysis was conducted to identify the homogeneous subgroups with distinct trajectories of self-care behaviors. Subsequently, multinomial logistic regression was used to assess whether baseline predictors were associated with these trajectories in patients with heart failure. Results Three distinct self-care behavior trajectory groups were identified: "low-decreased" (n = 33, 20.9%), "middle-increased" (n = 93, 58.9%), and "high-sustained" (n = 32, 20.2%). The multinomial logistic regression analysis showed that baseline adequate health literacy and positive social support significantly predicted patients' belonging to both the middle-increased and high-sustained self-care behavior trajectory groups compared to the low-decreased group. Importantly, better cognitive function at baseline was only significantly associated with the high-sustained self-care behavior trajectory compared to the low-decreased trajectory. Conclusion Our study revealed that only one-fifth of the patients belonged to the high-sustained self-care behavior group 6 months after hospital discharge. Strategies aimed at improving cognitive function, health literacy, and social support should be developed to sustain satisfactory self-care behaviors in patients with heart failure. Further studies with long-term follow-ups are required to identify other possible factors, as well as the baseline predictors of this study affecting longitudinal trajectories of self-care behaviors. Clinical relevance Healthcare providers should recognize and evaluate the distinct patterns of self-care behaviors over time in patients with heart failure. Importantly, assessing baseline cognitive function, health literacy, and social support before hospital discharge may be necessary to prevent a decline in self-care behaviors over time.
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