An insight on self-care determinates amongst de novo Acute Heart Failure (AHF) patients prior to their discharge: a descriptive study
2.18.2 - Bisogni e burden dei caregiver nello scompenso cardiaco; sono correlati con le caratteristiche dei pazienti e dei caregiver? Continuazione del progetto di ricerca
Among Europeans aged 60 and above, heart failure prevalence is above 10% in men and 8% in women. Patients presenting for the first time with typical symptoms and signs of acute heart failure (AHF) are classified as de novo AHF, which is a potentially life-threatening condition, requiring hospitalisation, and emergency treatment. Once the patients were stabilized and treated, their discharge plays a paramount role to address their follow-ups and educational strategies to enhance their self-care behaviours. Despite the important role of discharge, there is currently a lack in describing those patients self-care when they can be discharged from hospital.
To describe the self-care behaviours amongst de novo AHF patients and the assess the impact of clinical determinants on their self-care.
This study was descriptive, cross-sectional and mono-centric, using a convenience sampling approach. Patients were enrolled in a cardiac hospital of northern Italy within the 2017 and their self-care was assessed when they could be discharged from the hospital. The data were collected using validated tools, and the main variables were: socio-demographics, clinical determinants (e.g., NYHA, comorbidities) self-care maintenance (behaviours used to maintain stability), self-care management (response to signs and symptoms) and self-care confidence (self-efficacy), quality of life (QoL), and Activities of Daily Living (ADL). Multiple Logistic regressions were used to describe the relations between determinates and self-care.
From the final sample (n = 406 patients, 66% males, age ± DS = 65,56 ± 13,47 years), only the 18,5% had an adequate self-care maintenance, 7,1% had an adequate management and 35,5% had an adequate confidence. Males had twice than females the likelihood to have inadequate levels of maintenance (ORadjusted = 2,093; 95%CI = 1,109–3,950). Moreover, every point of perception of better QoL (using EuroQoL from zero to 100) was associated to an increase of the 4% in the likelihood of performing adequate self-care management behaviours (ORadjusted = 1,040; 95%CI = 1,005–1,075).
This study clearly showed the issues related of discharge for de novo AHF patients. Their self-care behaviours need to be supported and re-evaluated during their follow-ups. Further studies should deeply describe the investigated phenomena, using a longitudinal approach to detect the self-care trajectory over time