Comparison of self-care behaviors of heart failure patients in 15 countries worldwide

TLDR: Interventions that focus on specific self-care behaviors may be more effective than general educational programs and changes in some health care systems and national policies are needed to support patients with heart failure to increase theirSelf-care behavior.

About: This article is published in Patient Education and Counseling.The article was published on 2013-07-01 and is currently open access. It has received 212 citations till now. The article focuses on the topics: Disease management (health) & MEDLINE.

Figures

Table 1 Self-care behavior items in the Heart Failure of Self-care Index and the European Heart Failure Self Care Behavior scale.

Fig. 1. Percentages of low self-care behaviors per country.

Table 3 Low self-care per country. Low self-care was defined on the Self-care of Heart Failure Index as: never/rarely or only sometimes performing these behaviors. Low self-care on the European Heart Failure Self-care Behavior Scale was defined as not agreeing with the statement (scores 3, 4 and 5).

Table 2 Descriptive data per country.

Frequently asked questions

Q1. What contributions have the authors mentioned in the paper "Comparison of self-care behaviors of heart failure patients in 15 countries worldwide" ?

The authors aimed to describe self-care behaviors of patients from 15 countries across three continents. In all the samples, most patients reported taking their medications as prescribed but exercise and weight monitoring were low. In 14 of the 22 samples, more than 50 % of the patients reported low exercise levels. 

Q2. What have the authors stated for future works in "Comparison of self-care behaviors of heart failure patients in 15 countries worldwide" ?

Further changes in some health care system and national policies are needed in order to strengthen the possibilities for patients with HF to increase their self-care behavior. 

Q3. What is the purpose of the EHFScB scale?

EHFScB: The European Heart Failure Self-Care Behavior Scale (EHFScB scale) was developed to measure the behaviors that HF patients perform to maintain life, healthy functioning, and wellbeing [17]. 

Q4. What is the main focus of HF management programs?

Self-care is considered important in the comprehensive management of patients with HF and is the focus of HF management programs internationally. 

Q5. Why are there challenges in some countries?

Country specific challenges likely exist due to lack of resources, for example, salt restricted or healthy foods may be difficult to purchase in some countries [11] and weighing scales may not be affordable. 

Q6. What is the definition of HF specific self-care?

HF specific self-care includes activities aimed at self-care maintenance (e.g., taking medication, exercising), symptom monitoring (e.g., monitoring weight changes) and symptom management (e.g., calling a health care provider or taking extra diuretics with symptoms of fluid retention) [2–5]. 

Q7. What was the focus of the study?

That study focused mainly on the concepts of self-care maintenance, self-care management and self-care confidence and less on specific self-care behaviors. 

Q8. What are the implications of this study?

Practice implications: Interventions that focus on specific self-care behaviors may be more effective than general educational programs. 

Q9. What was the lowest rate of exercise in the sample?

Low rates of exercise (never/rarely/only sometimes on SCHFI or score >2 on the EHFScB scale) ranged from 36% in one of the samples from Germany to 90% in one of the Italian samples and 89% in the sample from Brazil. 

Q10. What are the items that address HF self-care?

Items address HF self-care maintenance (e.g., regular weighing, diet, fluids), self-care monitoring, and self-care management (e.g., warn a health care provider in case of weight gain). 

Q11. what countries reported the highest percentage of patients following a low salt diet?

Countries where the highest percentage of patients reported following a sodium restricted diet were the Netherlands (18%), Vietnam (22%) and Australia (23%). 

Q12. What was the common type of flu shot?

Receiving an annual flu shot varied widely among the countries; 16–75% of patients reported not getting an annual flu shot (median 38%).