看護とケアのジャーナル

Perceived social support and self-care in hospitalized heart failure patients

Abstract

Lyne Chamberlain

Statement of Problem: Self-care is recommended in heart failure (HF) management and to reduce hospitalizations, yet only one study has demonstrated improved patient outcomes with adequate self-care. This study evaluated perceived social support and self-care in hospitalized HF patients compared with community dwelling HF patients.

Methodology and Theoretical Orientation: The medical outcomes study of social support (MOS-SS) and the self-care of heart failure index (SCHFI) were the key measurement instruments for this multisite descriptive study.  Multiple regression and two-sample t tests for unequal variances were used to analyze the data from a convenience sample of 121 hospitalized HF patients and a comparative study of 211 community-dwelling HF patients. Theoretical frameworks were the Self-Care of HF Theory and the Stress-Buffering Model of the Social Support Theory.

Findings: Hospitalized HF patients had significantly lower self-care maintenance scores and perceived social support than community-dwelling HF patients.  Perceived social support was associated only with self-care confidence, and self-care confidence was associated with self-care maintenance and self-care management.  25% of hospitalized study candidates had cognitive impairment compared with less than 6% of community-dwelling patients.

Conclusion and Significance: Community-dwelling HF patients had better self-care skills than hospitalized HF patients.  Additional research is needed to determine the best strategies for improving self-care or reasonable substitutes in these patients. Additional research is also needed to evaluate cognitive impairment across the spectrum of HF patients, as this impairs self-care success.