• KSAN
  • Contact us
  • E-Submission

Korean J Adult Nurs : Korean Journal of Adult Nursing

OPEN ACCESS
mobile search button mobile menu button
Search
Advanced Search
ABOUT
BROWSE ARTICLES
EDITORIAL POLICY
FOR CONTRIBUTORS

Articles

Page Path

Original Article

Influence of Social Support and Negative Emotional Status on Self-care Adherence in Symptomatic Patients with Heart Failure

In-Suk Yang
Korean Journal of Adult Nursing 2016;28(3):302-313.
Published online: June 30, 2016

Department of Nursing, Kyungil University, Gyeongsan, Korea

Corresponding author: Yang, In-Suk Department of Nursing, Kyungil University, 50 Gamasil-gil, Hayang-eup, Gyeongsan 38428, Korea. Tel: +82-53-600-5664, Fax: +82-53-600-5679, E-mail: insookyang@gmail.com
• Received: April 5, 2016   • Accepted: June 20, 2016

Copyright © 2016 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • 14 Views
  • 2 Download
  • 2 Crossref
  • 2 Scopus
prev next

Full Article

Download PDF Download PDF
  • Purpose
    The objective of this study was to identify factors related to self-care adherence in symptomatic patients with heart failure (HF).
  • Methods
    Using a cross-sectional design, a convenience sample 209 outpatient clinic patients were recruited at two medical centers. Between October 2011 and August 2012, data were collected using the structured questionnaire. Factors related to self-care adherence were examined using hierarchical multiple regression.
  • Results
    Mean age of participants was 67.71 years and a half of them (53.6%) were female. They showed relatively low self-care adherence with mean scores of 61.88±12.92. Lower self-care adherence was reported in asking for low sodium items, weighing oneself, checking for ankle edema, and exercising for 30 minutes. The overall model significantly explained 23.9% of variance in self-care adherence. Among the predictors, education, New York Heart Association functional classification, and social support were statistically significant in influencing self-care adherence. The variable of negative emotional status such as anxiety and depression were not found to be significant.
  • Conclusion
    These findings demonstrate that social support could help self-care adherence among symptomatic patients with HF. Thus, programs targeting self-care adherence in this population should consider the strategies improving social support.
  • Key Words: Social support; Anxiety; Depression; Self care; Heart failure
Table 1.
Differences in Self-Care Maintenance based on Sociodemographic and Clinical Characteristics (N=209)
Characteristics Categories   n (%) or M±SD Self-care maintenance
M±SD t or F or r p (Scheffé)
Age (year) ＜65   69 (33.0) 65.00±13.87 3.19 .043
65~74   70 (33.5) 60.86±11.73    
≥75   70 (33.5) 59.82±12.68    
Gender Male   97 (46.4) 64.97±12.20 3.30 .001
Female   112 (53.6) 59.20±12.98    
Education completed No formal educationa   24 (11.5) 53.13±10.84 4.70 .001
≤Elementary schoolb   75 (35.9) 60.60±12.29   (a＜b, c, d, e)
≤Middle schoolc   29 (13.9) 64.48±12.72    
≤High schoold   43 (20.6) 63.60±12.61    
≥Collegee   38 (18.2) 65.99±13.45    
Spouse No   100 (47.8) 60.40±12.38 -1.59 .113
Yes   109 (52.2) 63.23±13.30    
Occupation Unemployed   146 (69.9) 60.72±12.86 1.99 .048
Employed   63 (30.1) 64.56±12.75    
Monthly income ($) ＜2,000   125 (59.8) 61.36±12.47 -0.71 .481
≥2,000   84 (40.2) 62.65±13.59    
NYHA classification IIa   126 (60.3) 64.86±11.55 15.11 ＜.001
IIIb   61 (29.2) 60.00±13.17   (a＞b, c)
IVc   22 (10.5) 50.00±12.30   (b＞c)
Left ventricular ejection fraction (%) ≤50   116 (55.5) 62.26±13.27 0.48 .632
＞50   93 (44.5) 61.40±12.51    
NT pro-BNP (pg/mL)     4,092.10±7,125.53 61.88±12.92 -.04 .526
Etiology Coronary artery disease   48 (23.0) 61.72±13.03 1.39 .248
Hypertension   51 (24.4) 60.34±12.01    
Valvular heart disease   28 (13.4) 63.75±11.81    
Cardiomyopathy   60 (28.7) 64.04±13.36    
Other   22 (10.5) 57.50±14.31    
Time since diagnosed (month) ≤60   112 (53.6) 61.21±12.78 0.91 .437
61~120   45 (21.5) 64.17±13.79    
121~180   24 (11.5) 59.48±12.81    
≥181   28 (13.4) 62.95±12.15    
Number of hospitalization     1.91±3.59 61.88±12.92 -.04 .109
Number of medication 1~2   34 (16.3) 64.12±16.35 2.45 .089
3~4   112 (53.6) 62.83±12.41    
≥5   63 (30.1) 58.97±11.35    
Comorbidity* MI Yes 26 (12.4) 61.15±14.08 -0.31 .761
No 183 (87.6) 61.98±12.78    
Cerebrovascular disease Yes 36 (17.2) 59.93±13.41 -0.99 .321
No 173 (82.8) 62.28±12.82 -0.99 .321
Diabetes mellitus Yes 64 (30.6) 62.23±11.67 0.26 .796
No 145 (69.4) 61.72±13.47    
Moderate-severe renal disease Yes 12 (5.7) 65.42±15.03 0.98 .330
No 197 (94.3) 61.66±12.79    
Ulcerative disease Yes 20 (9.6) 56.13±14.59 -1.88 .074
No 189 (90.4) 62.49±12.62    

NYHA=New York Heart Association; MI=Myocardial Infarction; NT pro-BNP=N-terminal prohormone of Brain Natriuretic Peptide; *Multiple responses.

Table 2.
Social Support, Negative Emotional Status, and Self-Care Maintenance (N=209)
Variables Categories n (%) Actual range M±SD
Social support     1~5 2.67±1.15
 Directive guidance     1~5 2.60±1.25
 Emotional support     1~5 2.84±1.27
 Tangible support     1~5 2.63±1.08
 Social interaction     1~5 2.76±1.24
Negative emotional status
 Anxiety 0~7 138 (66.0) 0~21 6.09±4.68
8~10 31 (14.8)    
11~21 40 (19.1)    
 Depression 0~7 105 (50.2) 0~21 8.00±4.76
8~10 48 (23.0)    
11~21 56 (26.8)    
 Self-care maintenance ＜70 150 (71.8) 27.50~100 61.88±12.92
≥70 59 (28.2)    
Table 3.
Descriptive Statistics for Individual Items of the Self-care Maintenance Scale (N=209)
Items Never or rarely Sometimes Frequently Always or daily M±SD
n (%) n (%) n (%) n (%)
Weigh oneself 68 (32.5) 80 (38.3) 47 (22.5) 14 (6.7) 2.03±0.91
Check ankles for swelling 73 (34.9) 71 (34.0) 43 (20.6) 22 (10.5) 2.07±0.99
Prevent disease (e.g., flu shot, avoid ill people) 28 (13.4) 53 (25.4) 76 (36.4) 52 (24.9) 2.73±0.98
Do some physical activity 40 (19.1) 48 (23.0) 51 (24.4) 70 (33.5) 2.72±1.12
Keep doctor or nurse appointments 3 (1.4) 12 (5.7) 61 (29.2) 133 (63.6) 3.55±0.67
Eat a low sodium diet 67 (32.1) 55 (26.3) 48 (23.0) 39 (18.7) 2.28±1.10
Exercise for 30 minutes 90 (43.1) 53 (25.4) 26 (12.4) 40 (19.1) 2.08±1.15
Forget to take one of medications 9 (4.3) 8 (3.8) 34 (16.3) 158 (75.6) 3.63±0.76
Ask for low sodium items when eating out or visiting others 135 (64.6) 47 (22.5) 15 (7.2) 12 (5.7) 1.54±0.86
Use a pill box or reminders to remember taking medications 98 (46.9) 33 (15.8) 33 (15.8) 45 (21.5) 2.12±1.22
Table 4.
Bivariate Associations among Key Variables (N=209)
Variables Categories Negative emotional status Self-care maintenance
Anxiety Depression
r (p) r (p) r (p)
Social support   -.41 (＜.001) -.42 (＜.001) .31 (＜.001)
Negative emotional status Anxiety - .73 (＜.001) -.31 (＜.001)
Depression - - -.33 (＜.001)
Table 5.
Hierarchical Regression Model of Predicting Self-care Maintenance in Patients with Symptomatic Heart Failure (N=209)
Step Variables Categories β t p
Step 1 Age 65~74 -.10 -1.26 .208
≥75 -.08 -0.96 .338
Gender Male .05 0.63 .532
Education completed Elementary school .25 2.40 .017
Middle school .24 2.46 .015
High school .22 2.09 .038
≥College .25 2.25 .026
Occupation Employed .01 0.17 .866
NYHA Class III -.13 -1.92 .056
Class IV -.32 -4.74 ＜.001
Adjusted R2=.16, F=4.73, p＜.001
Step 2 Age 65~74 -.11 -1.40 .163
≥75 -.13 -1.51 .133
Gender Male .05 0.57 .571
Education completed Elementary school .26 2.54 .012
Middle school .23 2.47 .014
High school .19 1.83 .069
≥College .22 2.03 .043
Occupation Employed .05 0.77 .441
NYHA Class III -.12 -1.78 .077
Class IV -.29 -4.31 ＜.001
Social support   .25 3.64 ＜.001
Anxiety   -.08 -0.85 .398
Depression   -.04 -0.37 .709
Adjusted R2=.24, F=6.03, p＜.001

R2 Change=.09 (p＜.001); NYHA=New York Heart Association; Reference (Age:＜65, Gender: Female, Education: No formal education, Occupation: Unemployed, NYHA: Class II).

  • 1.The Korean of Heart Failure. The manual of heart failure. Seoul: MMK comunications; 2007. p. 11-36.
  • 2.National Health Insurance Service. 『Heart Failure』 Over 80 years have 14 times higher HF patient rate than average [Internet]. Seoul: National Health Insurance Service; 2014. [cited 2015 July 1]. Available from:.http://www.nhis.or.kr/bbs7/boards/B0039/3171.
  • 3.Mavrea AM, Dragomir T, Bordejevic DA, Tomescu MC, Ancu-sa O, Marincu I. Causes and predictors of hospital readmissions in patients older than 65 years hospitalized for heart failure with preserved left ventricular ejection fraction in western Romania. Clinical Interventions in Aging. 2015;17:979-90. http://dx.doi.org/10.2147/CIA.S83750.
  • 4.Rodríguez Artalejo F, Guallar-Castillón P, Montoto Otero C, Conde Herrera M, Carreño Ochoa C, Tabuenca Martín AI, et al. Self-care behavior and patients' knowledge about self-care predict rehospitalization among older adults with heart failure. Revista Clínica Española. 2008;208(6):269-75.
  • 5.Tsuchihashi-Makaya M, Kato N, Chishaki A, Takeshita A, Tsu-tsui H. Anxiety and poor social support are independently associated with adverse outcomes in patients with mild heart failure. Circulation Journal. 2009;73(2):280-7. http://dx.doi.org/10.1253/circj.cj-08-0625.
  • 6.Heo S, Moser DK, Lennie TA, Riegel B, Chung ML. Gender differences in and factors related to self-care behaviors: a cross-sectional, correlational study of patients with heart failure. International Journal of Nursing Studies. 2008;45(12):1807-15. http://dx.doi.org/10.1016/j.ijnurstu.2008.05.008.
  • 7.Riegel B, Moser DK, Anker SD, Appel LJ, Dunbar SB, Grady KL, et al. State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation. 2009;120(12):1141-63. http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192628.
  • 8.Schnell-Hoehn KN, Naimark BJ, Tate RB. Determinants of self-care behaviors in community-dwelling patients with heart failure. Journal of Cardiovascular Nursing. 2009;24(1):40-7. http://dx.doi.org/10.1097/01.JCN.0000317470.58048.7b.
  • 9.Son YJ, Kim SH, Kim GY. Factors influencing adherence to self-care in patients with chronic heart failure. Korean Journal of Adult Nursing. 2011;23(3):244-54.
  • 10.Hu X, Hu X, Su Y, Qu M, Dolansky MA. The changes and factors associated with post-discharge self-care behaviors among Chinese patients with heart failure. Patient Preference and Adherence. 2015;9:1593-601. http://dx.doi.org/10.2147/PPA.S88431.
  • 11.Maeda U, Shen BJ, Schwarz ER, Farrell KA, Mallon S. Self-efficacy mediates the associations of social support and depression with treatment adherence in heart failure patients. International Journal of Behavioral Medicine. 2013;20(1):88-96. http://dx.doi.org/10.1007/s12529-011-9215-0.
  • 12.Oxman TE, Hull JG. Social support, depression, and activities of daily living in older heart surgery patients. The Journal of Gerontology. Series B, Psychological Sciences and Social Sciences. 1997;52B(1):P1-14.
  • 13.Fortmann AL, Gallo LC, Philis-Tsimikas A. Glycemic control among Latinos with type 2 diabetes: the role of social-environmental support resources. Health Psychology. 2011;30(3):251-8. http://dx.doi.org/10.1037/a0022850.
  • 14.Heo S, Moser DK, Chung ML, Lennie TA. Social status, health-related quality of life, and event-free survival in patients with heart failure. European Journal of Cardiovascular Nursing. 2012;11(2):141-9. http://dx.doi.org/10.1016/j.ejcnurse.2010.10.003.
  • 15.Gallagher R, Luttik ML, Jaarsma T. Social support and self-care in heart failure. Journal of Cardiovascular Nursing. 2011;26(6):439-45. http://dx.doi.org/10.1097/JCN.0b013e31820984e1.
  • 16.Lee ES, Shin ES, Hwang SY, Chae MJ, Jeong MH. Effects of tailored supportive education on physical, emotional status and quality of life in patients with congestive heart failure. Korean Journal of Adult Nursing. 2013;25(1):62-73. http://dx.doi.org/10.7475/kjan.2013.25.1.62.
  • 17.Khaledi GH, Mostafavi F, Eslami AA, Rooh Afza H, Mostafavi F, Akbar H. Evaluation of the effect of perceived social support on promoting self-care behaviors of heart failure patients referred to the Cardiovascular Research Center of Isfahan. Iranian Red Crescent Medical Journal. 2015;17(6):e22525-31. http://dx.doi.org/10.5812/ircmj.22525v2.
  • 18.Goodman H, Firouzi A, Banya W, Lau-Walker M, Cowie MR. Illness perception, self-care behaviour and quality of life of heart failure patients: a longitudinal questionnaire survey. International Journal of Nursing Studies. 2013;50(7):945-53. http://dx.doi.org/10.1016/j.ijnurstu.2012.11.007.
  • 19.Morgan K, Villiers-Tuthill A, Barker M, McGee H. The contribution of illness perception to psychological distress in heart failure patients. BMC Psychology. 2014;2(1):50-8. http://dx.doi.org/10.1186/s40359-014-0050-3.
  • 20.Barrera M Jr., Sandler IN, Ramsay TB. Preliminary development of a scale of social support: studies on college students. American Journal of Community Psychology. 1981;9(4):435-47. http://dx.doi.org/10.1007/BF00918174.
  • 21.Finch JF, Barrera M Jr, Okun MA, Bryant WHM, Pool GJ. Snow-Turek AL. Factor structure of received social support: dimensionality and the prediction of depression and life satisfaction. Journal of Social and Clinical Psychology. 1997;16(3):323-42.
  • 22.Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 1983;67(6):361-70.
  • 23.Oh SM, Min KJ, Park DB. A study on the standardization of the Hospital Anxiety and Depressed Scale for Koreans-a comparison of normal, depressed and anxious groups. Journal of Korean Neuropsychiatric Association. 1999;38(2):289-96.
  • 24.Riegel B, Carlson B, Moser DK, Sebern M, Hicks FD, Roland V. Psychometric testing of the self-care of heart failure index. Journal of Cardiac Failure. 2004;10(4):350-60. http://dx.doi.org/10.1016/j.cardfail.2003.12.001.
  • 25.Riegel B, Lee CS, Dickson VV, Carlson B. An update on the self-care of heart failure index. Journal of Cardiovascular Nursing. 2009;24(6):485-97. http://dx.doi.org/10.1097/JCN.0b013e3181b4baa0.
  • 26.Levy BR, Hausdorff JM, Hencke R, Wei JY. Reducing cardiovascular stress with positive self-stereotypes of aging. The Journal of Gerontology. Series B, Psychological Sciences and Social Sciences. 2000;55(4):P205-13.
  • 27.Damen NL, Pelle AJ, Szabó BM, Pedersen SS. Symptoms of anxiety and cardiac hospitalizations at 12 months in patients with heart failure. Journal of General Internal Medicine. 2012;27(3):345-50. http://dx.doi.org/10.1007/s11606-011-1843-1.
  • 28.Shimizu Y, Suzuki M, Okumura H, Yamada S. Risk factors for onset of depression after heart failure hospitalization. Journal of Cardiology. 2014;64(1):37-42. http://dx.doi.org/10.1016/j.jjcc.2013.11.003.
  • 29.Cocchieri A, Riegel B, D'Agostino F, Rocco G, Fida R, Alvaro R, et al. Describing self-care in Italian adults with heart failure and identifying determinants of poor self-care. European Journal of Cardiovascular Nursing. 2015;14(2):126-36. http://dx.doi.org/10.1177/1474515113518443.
  • 30.Graven LJ, Grant JS. Social support and self-care behaviors in individuals with heart failure: an integrative review. International Journal of Nursing Studies. 2014;51(2):320-33. http://dx.doi.org/10.1016/j.ijnurstu.2013.06.013.

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • An Integrated Literature Review on Cardiac Rehabilitation Program for Patients with Coronary Artery Disease
      Hong-A Lim, Yeoungsuk Song
      Journal of Health Informatics and Statistics.2024; 49(3): 205.     CrossRef
    • Self-care model based on the theory of unpleasant symptoms in patients with heart failure
      In-Suk Yang, Younhee Kang
      Applied Nursing Research.2018; 43: 10.     CrossRef

    Download Citation

    Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

    Format:

    Include:

    Influence of Social Support and Negative Emotional Status on Self-care Adherence in Symptomatic Patients with Heart Failure
    Korean J Adult Nurs. 2016;28(3):302-313.   Published online June 30, 2016
    DOI: https://doi.org/10.7475/kjan.2016.28.3.302
    Download Citation
    Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
    Format:
    • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
    • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
    Include:
    • Citation for the content below
    Influence of Social Support and Negative Emotional Status on Self-care Adherence in Symptomatic Patients with Heart Failure
    Korean J Adult Nurs. 2016;28(3):302-313.   Published online June 30, 2016
    DOI: https://doi.org/10.7475/kjan.2016.28.3.302
    Close

    Related articles

    Influence of Social Support and Negative Emotional Status on Self-care Adherence in Symptomatic Patients with Heart Failure
    Influence of Social Support and Negative Emotional Status on Self-care Adherence in Symptomatic Patients with Heart Failure

    Differences in Self-Care Maintenance based on Sociodemographic and Clinical Characteristics (N=209)

    Characteristics Categories   n (%) or M±SD Self-care maintenance
    M±SD t or F or r p (Scheffé)
    Age (year) ＜65   69 (33.0) 65.00±13.87 3.19 .043
    65~74   70 (33.5) 60.86±11.73    
    ≥75   70 (33.5) 59.82±12.68    
    Gender Male   97 (46.4) 64.97±12.20 3.30 .001
    Female   112 (53.6) 59.20±12.98    
    Education completed No formal educationa   24 (11.5) 53.13±10.84 4.70 .001
    ≤Elementary schoolb   75 (35.9) 60.60±12.29   (a＜b, c, d, e)
    ≤Middle schoolc   29 (13.9) 64.48±12.72    
    ≤High schoold   43 (20.6) 63.60±12.61    
    ≥Collegee   38 (18.2) 65.99±13.45    
    Spouse No   100 (47.8) 60.40±12.38 -1.59 .113
    Yes   109 (52.2) 63.23±13.30    
    Occupation Unemployed   146 (69.9) 60.72±12.86 1.99 .048
    Employed   63 (30.1) 64.56±12.75    
    Monthly income ($) ＜2,000   125 (59.8) 61.36±12.47 -0.71 .481
    ≥2,000   84 (40.2) 62.65±13.59    
    NYHA classification IIa   126 (60.3) 64.86±11.55 15.11 ＜.001
    IIIb   61 (29.2) 60.00±13.17   (a＞b, c)
    IVc   22 (10.5) 50.00±12.30   (b＞c)
    Left ventricular ejection fraction (%) ≤50   116 (55.5) 62.26±13.27 0.48 .632
    ＞50   93 (44.5) 61.40±12.51    
    NT pro-BNP (pg/mL)     4,092.10±7,125.53 61.88±12.92 -.04 .526
    Etiology Coronary artery disease   48 (23.0) 61.72±13.03 1.39 .248
    Hypertension   51 (24.4) 60.34±12.01    
    Valvular heart disease   28 (13.4) 63.75±11.81    
    Cardiomyopathy   60 (28.7) 64.04±13.36    
    Other   22 (10.5) 57.50±14.31    
    Time since diagnosed (month) ≤60   112 (53.6) 61.21±12.78 0.91 .437
    61~120   45 (21.5) 64.17±13.79    
    121~180   24 (11.5) 59.48±12.81    
    ≥181   28 (13.4) 62.95±12.15    
    Number of hospitalization     1.91±3.59 61.88±12.92 -.04 .109
    Number of medication 1~2   34 (16.3) 64.12±16.35 2.45 .089
    3~4   112 (53.6) 62.83±12.41    
    ≥5   63 (30.1) 58.97±11.35    
    Comorbidity* MI Yes 26 (12.4) 61.15±14.08 -0.31 .761
    No 183 (87.6) 61.98±12.78    
    Cerebrovascular disease Yes 36 (17.2) 59.93±13.41 -0.99 .321
    No 173 (82.8) 62.28±12.82 -0.99 .321
    Diabetes mellitus Yes 64 (30.6) 62.23±11.67 0.26 .796
    No 145 (69.4) 61.72±13.47    
    Moderate-severe renal disease Yes 12 (5.7) 65.42±15.03 0.98 .330
    No 197 (94.3) 61.66±12.79    
    Ulcerative disease Yes 20 (9.6) 56.13±14.59 -1.88 .074
    No 189 (90.4) 62.49±12.62    

    NYHA=New York Heart Association; MI=Myocardial Infarction; NT pro-BNP=N-terminal prohormone of Brain Natriuretic Peptide; *Multiple responses.

    Social Support, Negative Emotional Status, and Self-Care Maintenance (N=209)

    Variables Categories n (%) Actual range M±SD
    Social support     1~5 2.67±1.15
     Directive guidance     1~5 2.60±1.25
     Emotional support     1~5 2.84±1.27
     Tangible support     1~5 2.63±1.08
     Social interaction     1~5 2.76±1.24
    Negative emotional status
     Anxiety 0~7 138 (66.0) 0~21 6.09±4.68
    8~10 31 (14.8)    
    11~21 40 (19.1)    
     Depression 0~7 105 (50.2) 0~21 8.00±4.76
    8~10 48 (23.0)    
    11~21 56 (26.8)    
     Self-care maintenance ＜70 150 (71.8) 27.50~100 61.88±12.92
    ≥70 59 (28.2)    

    Descriptive Statistics for Individual Items of the Self-care Maintenance Scale (N=209)

    Items Never or rarely Sometimes Frequently Always or daily M±SD
    n (%) n (%) n (%) n (%)
    Weigh oneself 68 (32.5) 80 (38.3) 47 (22.5) 14 (6.7) 2.03±0.91
    Check ankles for swelling 73 (34.9) 71 (34.0) 43 (20.6) 22 (10.5) 2.07±0.99
    Prevent disease (e.g., flu shot, avoid ill people) 28 (13.4) 53 (25.4) 76 (36.4) 52 (24.9) 2.73±0.98
    Do some physical activity 40 (19.1) 48 (23.0) 51 (24.4) 70 (33.5) 2.72±1.12
    Keep doctor or nurse appointments 3 (1.4) 12 (5.7) 61 (29.2) 133 (63.6) 3.55±0.67
    Eat a low sodium diet 67 (32.1) 55 (26.3) 48 (23.0) 39 (18.7) 2.28±1.10
    Exercise for 30 minutes 90 (43.1) 53 (25.4) 26 (12.4) 40 (19.1) 2.08±1.15
    Forget to take one of medications 9 (4.3) 8 (3.8) 34 (16.3) 158 (75.6) 3.63±0.76
    Ask for low sodium items when eating out or visiting others 135 (64.6) 47 (22.5) 15 (7.2) 12 (5.7) 1.54±0.86
    Use a pill box or reminders to remember taking medications 98 (46.9) 33 (15.8) 33 (15.8) 45 (21.5) 2.12±1.22

    Bivariate Associations among Key Variables (N=209)

    Variables Categories Negative emotional status Self-care maintenance
    Anxiety Depression
    r (p) r (p) r (p)
    Social support   -.41 (＜.001) -.42 (＜.001) .31 (＜.001)
    Negative emotional status Anxiety - .73 (＜.001) -.31 (＜.001)
    Depression - - -.33 (＜.001)

    Hierarchical Regression Model of Predicting Self-care Maintenance in Patients with Symptomatic Heart Failure (N=209)

    Step Variables Categories β t p
    Step 1 Age 65~74 -.10 -1.26 .208
    ≥75 -.08 -0.96 .338
    Gender Male .05 0.63 .532
    Education completed Elementary school .25 2.40 .017
    Middle school .24 2.46 .015
    High school .22 2.09 .038
    ≥College .25 2.25 .026
    Occupation Employed .01 0.17 .866
    NYHA Class III -.13 -1.92 .056
    Class IV -.32 -4.74 ＜.001
    Adjusted R2=.16, F=4.73, p＜.001
    Step 2 Age 65~74 -.11 -1.40 .163
    ≥75 -.13 -1.51 .133
    Gender Male .05 0.57 .571
    Education completed Elementary school .26 2.54 .012
    Middle school .23 2.47 .014
    High school .19 1.83 .069
    ≥College .22 2.03 .043
    Occupation Employed .05 0.77 .441
    NYHA Class III -.12 -1.78 .077
    Class IV -.29 -4.31 ＜.001
    Social support   .25 3.64 ＜.001
    Anxiety   -.08 -0.85 .398
    Depression   -.04 -0.37 .709
    Adjusted R2=.24, F=6.03, p＜.001

    R2 Change=.09 (p＜.001); NYHA=New York Heart Association; Reference (Age:＜65, Gender: Female, Education: No formal education, Occupation: Unemployed, NYHA: Class II).
    Table 1. Differences in Self-Care Maintenance based on Sociodemographic and Clinical Characteristics (N=209)

    NYHA=New York Heart Association; MI=Myocardial Infarction; NT pro-BNP=N-terminal prohormone of Brain Natriuretic Peptide; *Multiple responses.

    Table 2. Social Support, Negative Emotional Status, and Self-Care Maintenance (N=209)

    Table 3. Descriptive Statistics for Individual Items of the Self-care Maintenance Scale (N=209)

    Table 4. Bivariate Associations among Key Variables (N=209)

    Table 5. Hierarchical Regression Model of Predicting Self-care Maintenance in Patients with Symptomatic Heart Failure (N=209)

    R2 Change=.09 (p＜.001); NYHA=New York Heart Association; Reference (Age:＜65, Gender: Female, Education: No formal education, Occupation: Unemployed, NYHA: Class II).

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

    Korean J Adult Nurs : Korean Journal of Adult Nursing

    ABOUT

    BROWSE ARTICLES 

    EDITORIAL POLICY

    FOR CONTRIBUTORS  

    © Korean Society of Adult Nursing.
    TOP