| Patients with heart failure (HF) are frequently hospitalized due to excessive sodium intake. A behavior promotion model, The Common Sense Model of Illness Representation, was used to determine predictors of self-efficacy for low sodium diet behaviors (Diet SE). When this model was used in non-HF illnesses, the level of threat imposed by implicit illness representation (knowledge about the meaning of an illness [illness beliefs] and symptoms of illness severity [objective cues]) prompted coping through self care behaviors. In addition to the direct threat imposed by an implicit representation, the emotional response to the representation prompted coping.; Hypotheses: In patients with HF, (1) accuracy of HF beliefs strengthens Diet SE; (2) greater number of objective HF cues strengthens Diet SE; (3) accuracy of HF beliefs strengthens Diet SE when HF is asymptomatic or mild; (4) depression lessens Diet SE; (5) a combination of HF beliefs, objective HF cues, and depression together predict Diet SE; and (6) when controlling for prespecified control variables, the relationships in hypothesis 5 hold.; In 219 patients, more were Caucasian, elderly, married, educated, and nondepressed. Overall, patients had inaccurate HF beliefs and mild objective cues of HF severity. Accurate HF beliefs (all patients and those with mild HF) and number of objective cues did not predict Diet SE (Hypothesis [Ho] I, 2, and 3). Higher depression predicted less strength in resisting relapse and total Diet SE (Ho 4). When combining predictor variables (Ho S), the model predicted resisting relapse for Diet SE, but not reducing salt, behavioral skills, or total Diet SE. Age, someone to confide in, and diabetes were associated with Diet SE. After adjusting for these variables, the original combination model relationship with resisting relapse for Diet SE was lost due to the effect of someone to confide in but retained when age and diabetes were entered (Ho 6).; Since HF beliefs and cues of severity did not create enough threat to promote Diet SE, nurses must assess patient education protocols, especially if symptoms provide the rationale for self-care adherence. Assessment of depression is needed so that diagnosis and treatment are promoted. |
