Correlation Between Frailty And Self-care Behaviors In Elderly Patients With Heart Failure

ObjectivesThe purpose of the present study was to assess frailty and self-care behaviors in elderly patients with heart failure,to analyze the influencing factors of frailty and self-care behaviors,and to evaluate the correlation between frailty and self-care behaviors in elderly patients with heart failure.According to the results,suggestions for clinical treatment and nursing of elderly patients with heart failure are provided,which provides a reference for further improving self-care behaviors of elderly patients with heart failure.MethodsConvenient sampling was used to select elderly patients with heart failure who were admitted to the Department of Cardiology,a top hospital in Changchun,Northeast China,from March 2018 to November 2018.All patients met the inclusion criteria and signed informed consent.We collected questionnaires through face-to-face interviews.The tools we used: General Information Questionnaire,Disease Related Information Questionnaire,Comorbidity Index Questionnaire,Mini-Mental State Exam,Tilburg Frailty Indicator and Self-care of Heart Failure Index(V6).Using EpiData 3.1 software input data,and SPSS 21.0 software statistically analyzed data.Descriptive analysis was conducted on patient’s general demographic characteristics,disease characteristics,frailty,and self-care behaviors.The count data was presented in frequency and percentage,and the measurement data was presented in SX ± or median,and quartile.Correlation analysis using Pearson correlation coefficient method.Using single factor analysis and multiple stepwise regression method to analyze influencing factors of frailty and self-care behaviors.Results1.A total of 165 hospitalized patients with heart failure was investigated.Finally,150 filled in the questionnaire completely.The patients had a mean TFI score was 6.70±2.59 points,their mean physical component score of 3.86±1.51 points,their mean emotional component score was 2.95±1.27 points,and their mean social component score was 0.90±0.69 points.2.The highest rate of physical component in elderly patients with heart failure was physical tiredness(92.7%),self-reported unhealthy(82.7%),difficulty in walking(61.3%);the highest rate of emotional component was depressive symptoms(63.3%),nervousness or anxiety(48.7%),cognition(48.7%);the highest rate of social component was social relationships(68.7%).3.Factors that influenced the frailty of elderly patients with heart failure include: income,number of hospitalizations in the past year,status of exercise,and chronic lung disease complications.4.The mean standard of two domains of Self-care of Heart Failure Index were 53.11±20.35 and 56.67±12.69.Only 23.33% of the sample had adequate self-care maintenance scores,14.00% of the sample had adequate self-care management scores.Better behaviors in self-care maintenance were taking medications,physical activity and checking ankle edema,poor behaviors in self-care maintenance were weighting,using a system to remember medicines and exercising for 30 minutes.Better behaviors in self-care management were recognizing a symptoms of heart failure,taking an extra water pill and low-salt diets,poor behaviors in self-care management were calling your doctor or nurse,reducing fluid intake and thinking a remedy to reduce symptoms.Negative correlations were found between self-care behaviors and frailty and its three components.5.Multiple stepwise regression analysis showed that factors affecting the self-care maintenance in elderly patients with heart failure were frailty,with or without surgery,emotional frailty,severity of comorbidities and income.Factors affecting self-care management in elderly patients with heart failure were frailty and income.Conclusions1.The rate of frailty in elderly patients with heart failure is high,not only physical frailty but also emotional frailty,social frailty.This suggests that medical staff should multi-dimensionally assess the frailty of elderly patients with heart failure.2.The highest rate of physical component in elderly patients with heart failure was physical tiredness,self-reported unhealthy,difficulty in walking;the highest rate of emotional component was depressive symptoms,nervousness or anxiety,cognition;the highest rate of social component was social relationships.This suggests that medical staff can focus on these aspects when intervening frailty of elderly patients with heart failure.More intervention should be given to patients with low income,frequent admission,no sports,and comorbidities.3.The self-care behavior of elderly patients with heart failure is at a low level and significantly associated with frailty.Multiple stepwise regression analysis showed that factors affecting self-care maintenance were frailty,with or without surgery,emotional frailty,severity of comorbidities and income,factors affecting self-care management were frailty and income.This suggests that health care workers pay more attention to assess these parts,slow down the process of frailty,to improve the patient’s self-care behaviors,finally improve patient’s prognosis.