| Heart failure (HF) is a complex, debilitating cardiovascular disorder that is reaching epidemic proportions in the United States. Today, HF is affecting more than five million people in the United States. Despite improved medical and surgical management, HF outcomes remain poor. Heart failure self-care is a promising strategy to improve heart failure outcomes. However, several factors are hindering the practice of self-care among patients with heart failure. The purpose of this study was to test a model of factors that affect HF self-care to determine which of these factors would serve as predictors of self-care practice among patients with HF. Guided by Orem's Self-Care Theory, the proposed model in this study included the following factors: age, gender, ethnicity, resilience, functional health status, perceived autonomous family support, and perceived autonomous healthcare practitioner support. A correlation design was used to evaluate the influence of the independent variables on heart failure self-care maintenance and management. Data were collected from 395 patients using sets of survey. Data were analyzed using the Structural Equation Modeling (SEM) technique. The predictors of self-care maintenance included age (= -0.13, p < 0.01), functional health status (= -0.19, p < 0.001), and perceived autonomous support from healthcare professionals (= 0.88, p < 0.001). The predictors of self-care management included age (= -0.30, p < 0.01), functional health status (= -0.63, p <0 .01), resilience (= 0.36, p < 0.01), perceived autonomous support from family (= 0.26, p < 0.01), and perceived autonomous support from healthcare practitioners (= 0.20, p < 0.01). The model of this study explained 73% of the variance in self-care maintenance and 34% of the variance in self-care management. Age, health status, and autonomous healthcare practitioners' support severed as strong predictors of self-care. Resilience and autonomous support from family were moderate predictors. More research is needed to verify and support the findings of this study and to explain the remaining variance in HF self-care. |
