Cognitive Function In Patients With Chronic Heart Failure And Its Effect On Self-care

Background Self-care is defined as an active, cognitive decision-making process. The chronic heart failure (CHF) patients’engagement in self-care plays a vital role in disease control. Current evidence suggests that patients with CHF have a lower level of self-care activities. The influence factors which have been found can just explain a small part of the variance of self-care. To explore the influence factors in deep, foreign researchers begin to pay attention to cognitive function and self-care in patients with heart failure recently. However, it hasn’t been noticed in our country. It’s necessary to explore the effect of cognitive function on self-care in a sample of patients with heart failure in China. If the relevance exists indeed, the patients with cognitive impairment should be screened out and provided with continuous care service in priority.Objective Describe the cognitive function in patients with chronic heart failure. Explore the effect of cognitive function on self-care in patients with chronic heart failure.Methods Using a cross-sectional research design, CHF patients (n=267) were recruited from two care units-Heart Failure Care Unit and Intensive Care Unit of a hospital specialized in cardiovascular disease in Beijing. Through the Montreal Cognitive Assessment (MoCA) and Self-Care in Heart Failure Index (SCHFI), researchers collected the related data.Results Overall the group were adult and old (mean age63.78SD9.43years), predominantly male (63.3%). The percentage of patients with NYHA class Ⅲ or Ⅳ was87.6%and62.2%of the participants’ LVEF was less than45%. Based on the MoCA score,18.4%(score<24) and37.8%(score<26) of patients suffered from cognitive impairment with the three specific cognitive functions-memory, langue and executive capability most seriously impaired. The mean standard score of two domains of SCHFI were54.53(SD13.39) and50.71(SD14.62) respectively. According to the SCHFI, the standard scores>70are considered to reflect adequate self-care. Only11.2%of the sample had adequate self-care maintenance scores;13.5%had adequate self-care management. Multiple linear regression analysis indicated that cognitive function, age, level of education and depression accounted for24.4%of the total variance in self-care maintenance; cognitive function, marital status, level of education and depression explained28.6%of the variance in self-care management. After removing cognitive function from the regression equation, the percentage of variance explanation decreased17.3%and16.8%in self-care maintenance and management respectively.Conclusions Higher rates of cognitive impairment and widely damaged dimensions-memory, langue and executive capability exist in patients with chronic heart failure. As for self-care of CHF patients, reminding taking medicine, regular follow-up, condition monitoring, symptom recognization, consulting doctors or nurses, and taking additional diuretic should be improved, In our study, cognitive function is a strong determinant of self-care in CHF patients.