Relationship between self-care behaviors and quality of life in patients with heart failure

Psychometric Evaluation of the Persian Version of Spiritual Self-Care Practice Scale in Iranian Patients with Cancer

Spiritual self-care is defined as a set of patient-centered or family-centered spiritual activities aimed at promoting health and well-being. In chronic diseases such as cancer, the responsibility for care typically falls on the patient or their family, necessitating an accurate assessment of the patient's self-care practices to achieve this goal. The objective of this study was to translate, culturally adapt, and examine the psychometrics of the Persian version of the spiritual self-care practice scale (SSCPS) in cancer patients. This scale is designed to be administered directly to patients to assess their spiritual self-care practices. This cross-sectional study was conducted at the oncology ward in Afzalipoor Hospital, Javad Al-Aemeh Clinic, and Physicians Clinics affiliated with Kerman University of Medical Sciences in Kerman, southeast Iran. The study included qualitative and quantitative assessments of face validity, content validity, item analysis, exploratory and confirmatory factor analysis (construct validity), and reliability. Data collection took place between March 20, 2023, and December 30, 2023. The scale's content validity index was calculated to be 0.948, with mostly minor revision comments for most items. The item-content validity indices ranged from 0.7 to 1. Exploratory factor analysis revealed a five-factor solution with 23 items, explaining 61.251% of the total variance. The identified factors were labeled as 'personal and interpersonal spiritual practices,' 'shaping and strengthening relationship practices,' 'religious practices,' 'physical spiritual practices,' and 'reshaping relationship practices.' Most of the confirmatory factor analysis indices were satisfactory (χ2/df = 1.665, CFI = 0.934, IFI = 0.935, RMSEA = 0.058). The Cronbach's α coefficient for the total scale was 0.89, while it ranged from 0.596 to 0.882 for the subscales. The Persian version of SSCPS with 23 items demonstrates reliability and effectiveness in assessing the spiritual practice performance of Iranian cancer patients. Compared to the original version, the Persian adaptation of SSCPS is concise, making it a suitable instrument for future research and practice on spiritual self-care among Iranian cancer patients.

Health-related quality of life of people with heart failure in low- and middle-income countries: a systematic review and meta-analysis

PURPOSE

Heart failure is a global health concern and associated with poor health-related quality of life and increased mortality. There is a disproportionate burden on patients and health systems in low- and middle-income countries. This systematic review and meta-analysis estimates the health-related quality of life of people with heart failure in low- and middle-income countries.

METHODS

A systematic literature search was conducted to identify relevant studies from January 2012 to November 2022 using the following databases: MEDLINE, EMBASE, PsycINFO, CINAHL, Web of Science, Scopus and JBI EBP database. Study screening, quality appraisal and data extraction were conducted using JBI methodology. A random-effects model was used to perform the meta-analysis. Heterogeneity was assessed using the I2 statistic. All statistical analyses were done in STATA version 17.

RESULTS

A total of 33 studies with 5612 participants were included in this review. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the Short-Form-36 questionnaire (SF-36) were the most used instruments across 19 and 8 studies, respectively. The pooled mean MLHFQ and SF-36 scores using the random-effects model were 46.08 (95% CI 35.06, 57.10) and 41.23 (95% CI 36.63, 45.83), respectively. In a subgroup analysis using both instruments, the highest health-related quality-of-life scores occurred in studies with inpatient participants.

CONCLUSION

The overall health-related quality of life of people with heart failure in low- and middle-income countries is poor. Strategies should be strategically developed to improve the health-related quality of life of people with heart failure in these countries.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42022377781.

Investigating the predictive role of spiritual health, social support, and quality of life in self-care behaviors among heart failure patients

BACKGROUND

Self-care behaviors, which have a vital role in the management of heart failure disease, are influenced by several factors that are of paramount importance. This study aimed to determine the predictive role of spiritual health, social support, and quality of life in self-care behaviors among heart failure patients.

MATERIALS AND METHODS

This descriptive-analytical study was conducted from July to September 2021 on 203 patients with heart failure. Samples were selected by convenience sampling method from six centers in Ahvaz city. Data were collected using a clinical-demographic information questionnaire, the European Heart Failure Self-care Behavior Scale (EHFScBs), the Multidimensional Scale of Perceived Social Support (MSPSS), the 12-Item Short Form Health Survey (SF-12), and Paloutzian and Ellison's Spiritual Well-being Scale. Data analysis was performed with SPSS 16 using descriptive and analytical statistical methods including Pearson's correlation coefficient, regression analysis, independent t-test, and analysis of variance.

RESULT

The mean and standard deviation of the age of the female and male participants were 63.54 ± 14.03 and 62.34 ± 13.79, respectively. The majority of the participants (54.2%) were female, had primary education (23.2%), and were married (82.8%). Statistically significant relationships were observed between perceived social support and self-care (r = -0.22, P < 0.01), between spiritual health and self-care (r = -0.39, P < 0.01), and between the quality of life and self-care (r = 0.62, P < 0.01). However, no such relationship was found between demographic characteristics and self-care.

CONCLUSION

Considering the predictive role of spiritual health, social support, and quality of life in self-care behaviors, it is necessary for planners to pay special attention to these factors when designing educational-supportive programs for these patients.

Patient’s knowledge, gender, and physical activity level as the predictors of self-care in heart failure patients

Introduction: Self-care management is the fundamental approach for Heart Failure (HF) management and is influenced by patient ability in preventing rehospitalization, mortality, and morbidity. Therefore, this study aims to investigate the predictors of a patient’s ability in HF self-care management. Design and Methods: A cross-sectional study was carried out on 96 patients with HF. The data were collected through interviews using questionnaires on demographic characteristics, physical activity (IPAQ), knowledge (Dutch Heart Failure Knowledge Score), and self-care management (Self Care Heart Failure Index). Subsequently, the data were analyzed using logistic regression analysis, and the best fit model for predicting self-care management in HF patients was generated. Results: The proportion of samples was 56.3% female, with mostly primary school (50%) as their education level. Furthermore, the proportion of patients with adequate HF self-care management was only 21% of the total participant. Based on the results, the patient’s physical activity level, HF knowledge, and gender were verified as a predictor of self-care management. Conclusions: The HF knowledge level, physical activity level, and gender were the predictors of HF self-care management.

Self-Care and Quality of Life Among Adult Patients With Heart Failure: Scoping Review

Introduction

Although self-care has a therapeutic effect on heart failure (HF), patients experience a marked reduction in physical and executive function, resulting in poor quality of life (QoL). A literature review revealed limited evidence regarding the possible relationship between self-care and QoL in HF patients. Therefore, this scoping review aimed to identify scientific evidence that examines the extent of self-care, QoL, and relationship between self-care and QoL in patients with HF.

Methods

Full-text research published from March 23, 2010, to March 23, 2020, written in English, that had content on both self-care and QoL among adult patients with HF was included. A literature search of electronic databases and web searches was conducted for published articles. Four databases were used: MEDLINE, Scopus, Web of Science, and the Cochrane Library. Studies collected from Google and Google Scholar web searches were also included.

Results

Of 1,537 papers identified by the search, 12 were included. The reviewed studies included 3,127 patients. Ten articles used a cross-sectional study design, whereas the remaining articles used a longitudinal and quasi-experimental design. This review found that the extent of self-care practices among patients with HF was inadequate, a significant proportion of patients enrolled in the reviewed studies had a moderate QoL, and higher self-care practices were associated with a better QoL. Self-care behavior and QoL were affected by social support, sex, age, educational level, place of residence, illness knowledge, presence of comorbidities, and functional classification of HF.

Conclusion

Self-care behavior was positively correlated with QoL in patients with HF. Self-care and QoL in these patients have been reported to be affected by several factors. Further research with a rigorous study design is recommended to investigate the influence of self-care practices on QoL in patients with HF.

Adherence to Self-Care Behaviors and Associated Factors among Adult Heart Failure Patients Attending Chronic Follow-Up Care at Jimma University Medical Center, Southwest Ethiopia

Background:

Optimal outcomes and quality of life in patients with heart failure (HF) depend on effective self-care activities. However, patients may experience difficulties, and their performance may be inconsistent.

Aim:

To determine the level of adherence to self-care behaviors and associated factors among adult HF patients attending chronic follow-up care at Jimma University Medical Center (JUMC).

Methods:

A cross-sectional study was conducted between August and September 2021. Data were collected through face-to-face interviews and by reviewing patients’ medical records. The collected data were analyzed using SPSS version 25 and the findings were presented in frequency, percentage, mean (SD), and median (IQR). Multivariate logistic regression was performed to determine factors associated with adherence to self-care behaviors. Odds ratios with 95% confidence intervals and p-values were used to report the findings.

Results:

Out of 266 HF patients, 50.0% had good adherence towards self-care behavior recommendations. The highest following recommendation was taking medication as prescribed (75.5%), followed by a dietary recommendation of a low-salt diet (45.2%). Participants who could not read and write (adjusted odds ratio (AOR) = 0.30 (95% confidence interval (CI) 0.13, 0.71), P = 0.006), had an illness duration greater than or equal to ten years (AOR = 0.31 (95% CI 0.12, 0.82), P = 0.02), in the NYHA class II HF (AOR = 0.33 (95% CI 0.15, 0.73), P = 0.007) were negatively associated with good adherence to self-care behavior recommendations.

Conclusion:

In this study, only half of the respondents had good adherence to self-care behaviors. Lower educational level, longer illness duration, and NYHA class II HF were predictors of poor adherence to self-care. Therefore, nurses should devise strategies to counsel or educate the HF patients on self-care practice recommendations, particularly patients with a lower education level and who lived longer with HF.

Impact of COVID-19 pandemic on psychological health of a sample of the health care workers in the western region of Kingdom of Saudi Arabia

Background

The coronavirus disease 2019 pandemic has shown a significant impact on the psychological well-being of health care workers. The aim of the study was to evaluate the impact of the COVID-19 pandemic on the psychological health of health care workers in the Kingdom of Saudi Arabia. During the months of November and December, 283 health care workers completed a survey containing measures of depression, anxiety and stress (using Depression Anxiety and Stress-21 scale [DASS-21]) and questions regarding potential predictors such as the role of COVID-19 perception, availability of mental health support and work-related factors. Pearson X² test revealed factors associated with the presence of significant psychiatric symptoms.

Result

Among the participants, 17.3% screened positive for depression, 26.2% for anxiety and 17.3% for stress. Nurses reported significantly more depression, anxiety and stress than doctors. Those who received mental health support reported significantly lesser depression, anxiety and stress. Those who felt that quality of life was heavily impacted due to COVID-19 reported significantly high depression, anxiety and stress.

Conclusions

Poor psychological well-being was prevalent in health care workers; however, mental health measures have been shown to significantly reduce the mental health burden in health care workers.

Linking residents' perceptions of pandemic quality of life with their support for sustainable tourism development in the post-COVID-19 era

The COVID-19 pandemic has changed tourist flows, reducing the number of international tourist arrivals around the world. One of the ways to protect the tourism industry from the ongoing health crisis was through the stimulation of domestic and proximity tourism. During the COVID-19 pandemic in Serbia, domestic tourists were attracted to spa destinations such as Vrnjačka Banja. Thus, residents of this small-town destination experienced a great influx of tourists, altering their everyday lives. This paper examines the quality of life domains of Vrnjačka Banja residents during the pandemic and their support for sustainable tourism initiatives in the viable future. Study findings suggest that spirituality and support from friends and general quality of life as identified domains of quality of life during the pandemic emerged as antecedents of support for sustainable tourism. The study contributes to the existing tourism knowledge by acknowledging the capacity of different domains of residents" quality of life in the pandemic context to frame future sustainable tourism initiatives.

Do it yourself: The role of early self-care ability in social skills in Japanese preschool settings

Self-care ability and social skills are potential areas of difficulty for preschool children. However, values about young children's self-care ability are different worldwide. This longitudinal study examined the influence of early self-care ability on social skills at the end of the preschool years. Participants were 509 children recruited from kindergartens and child care centers across Japan, whose self-care ability and social skills were assessed at baseline year and three years later (Age of children in 2015 at baseline: M  =  35 months, SD  =  6.1 months). The study found that gender was significantly associated with social skills, while preschool facility entrance age was only associated with assertion skills. After controlling gender and entrance age, early self-care ability was still positively related to later assertion and cooperation (Assertion: OR  =  2.55, 95% CI  =  1.00–6.51; Cooperation: OR  =  3.15, 95% CI  =  1.23–8.07). Implications of the findings are discussed in the context of cultural diversity, highlighting the importance of cultivating children's age-appropriate self-care ability based on daily observations and evaluations.

Effectiveness of self-care program on the quality of life in patients with coronary artery disease undergoing cardiac rehabilitation: A Randomized clinical trial

BACKGROUND

Coronary artery disease (CAD) is a life-threatening condition that causes physical and psychological disorders and decreases patients' quality of life (QoL). Performing proper educational self-care program may lead to higher QoL in these patients. This study was performed to investigate the effectiveness of a self-care educational program on QoL in patients with CAD.

MATERIALS AND METHODS

This semi-experimental study was performed on 60 patients with CAD referred to the cardiac rehabilitation (CR) center of Vali Asr hospital in Qom, Iran, in 2018-2019. Patients were divided into control and intervention groups by randomized sampling. The self-care educational program was provided through lectures and booklet. Data collection was done using the "demographic and clinical data questionnaire," and "Seattle Angina questionnaire." Questionnaires were completed in both groups, before and at least 1 month after education. Analysis of the obtained data was performed using SPSS software (version 25), central indexes, Mann-Whitney test, and Wilcoxon test.

RESULTS

No significant differences were observed between the two groups for demographics characteristics and quality of life before the intervention. Before the self-care program, the mean score of the QoL in the intervention and control group were 56.14 ± 9.75 and 58.46 ± 11.71, respectively. After that, the mean score of the QoL in the intervention and control group were 59.25 ± 10.56 and 59.7 ± 13.33, respectively. The statistical analysis showed significant differences in the mean scores of QoL in the intervention group before and after the intervention (P < 0.05). However, no statistically significant differences were seen in the control group before and after the study (P > 0.05).

CONCLUSIONS

The self-care educational program improved the QoL in patients with CAD. Therefore, lectures and educational booklets should be considered by CR nurses.

The effect of educational intervention based on Pender's health promotion model on quality of life and health promotion in patients with heart failure: an experimental study

BACKGROUND

Heart failure is a common and chronic heart condition with high prevalence and mortality rates. This debilitating disease as an important predictor of health outcomes is directly related to patients' quality of life. Given that one of the main goals of heart failure treatment is to promote patients' quality of life and health status, conducting effective nursing interventions seems to be necessary in this regard. Therefore, the present study aimed to determine the effect of educational intervention based on Pender's health promotion model on quality of life and health promotion in patients with heart failure.

METHODS

This is an experimental study in which a total of 80 patients with heart failure were recruited and randomly allocated to two groups of intervention and control (n = 40 in each group). The educational program was designed based on Pender's health promotion model and then provided for the patients in the intervention four subgroups (10 person in each group) during six sessions. Data were collected at three time-points of before, immediately after, and three months after the intervention using a demographic questionnaire, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the Health-Promoting Lifestyle Profile II (HPLP-II). Data were then analyzed using SPSS Statistics for Windows, version 17.0 (SPSS Inc., Chicago, Ill., USA) and p value less than 0.05 was taken as statistically significant.

RESULTS

Based on the results of the present study, no statistically significant difference was shown in terms of demographic characteristics between the two groups. It was also indicated that there was a statistically significant difference in the mean scores of all dimensions of quality of life (except in the physical dimension) between the two groups so that the overall mean score of quality of life increased significantly in the intervention group after the intervention (p < .05). Moreover, there were significant increases in the mean scores of health-promoting behaviors (except in the domain of physical activity) in the intervention group compared to the control group (p < .05) after intervention.

CONCLUSIONS

This study demonstrates a trend that Pender's health promotion model is effective in improving the quality of life of patients with heart failure except of the physical dimension, and strengthening their health-promoting behaviors in all dimensions except of the physical activity dimension.

Outcomes of nurse-led telecoaching intervention for patients with heart failure: A systematic review and meta-analysis of randomised controlled trials

BACKGROUND

Studies have identified that nurse-led telephone health coaching benefited the continuity of care in patients with heart failure. However, the effect of nurse-led telephone health coaching remains inconclusive among the previous studies.

AIM

This review aimed to determine the effects of nurse-led telecoaching among patients with heart failure.

DESIGN

This study was a systematic review and meta-analysis of randomised controlled trials. This study was reported in accordance with the PRISMA guideline.

METHODS

Seven databases (PubMed, Embase, CINAHL, Web of Science, MEDLINE, Cochrane library and Ovid) were electronically searched up to 20 October 2020. The eligibility criteria were a randomised controlled trial study on heart failure patients, with the intervention led by a nurse through telephone coaching. Two authors independently evaluated the methodological quality using the modified Jadad scale. The Comprehensive Meta-Analysis software version 3.0 with a random effect model was used to conduct a meta-analysis, and Begg's and Egger's tests were performed to assess publication bias. Furthermore, sensitivity analysis was carried out.

RESULTS

A total of 12 randomised controlled trials were met eligibility criteria and representing 1938 heart failure patients. The results showed that the nurse-led telecoaching significantly enhanced patients' self-care behaviour (SMD = .84, 95%CI [0.45-1.24], p < .001) and improved quality of life (SMD = .23, 95%CI [0.06-0.39], p = .007).

CONCLUSION

Nurse-led telecoaching appears to enhance self-care behaviour and improve quality of life in patients with heart failure. Further research needs to build the evidence for nurse-led telecoaching intervention, including understanding its mechanisms of action (e.g. frequency, components) and identifying its moderating factors.

RELEVANCE TO CLINICAL PRACTICE

Implementation of nurse-led telecoaching is deemed helpful in promoting continuity of care because it was an accessible and sustainable intervention to improve patients' self-care and quality of life.

Self-care Behavior and Frailty Syndrome among Elderly Patients with Heart Failure

BACKGROUND: The development of technology gives an impact on life expectancy in the elderly. In Yogyakarta, the total of the elderly was higher than in other provinces in Indonesia. The elderly experience a decreased functional state that may lead to impaired body organs, such as heart failure. Heart failure has increasingly become a serious health problem. At present, 80% of elderly patients experience heart failure because of a decrease in functional status. The elderly may also experience frailty syndrome, which can provide a poor prognosis in terms of mortality, rehospitalization, and quality of life. It needs complex management; one of these is self-care behavior that can prevent the spread of frailty syndrome. AIM: The study aims to assess the correlation between self-care behavior and frailty syndrome in elderly patients with heart failure. METHODS: The study included 87 elderly patients with heart failure who visited the cardiology outpatient unit in two private hospitals. Self-care was measured using the self-care heart failure index, and frailty syndrome was assessed using the frailty index. A correlation test was conducted using Spearman rho. RESULTS: The result showed inadequate self-care behavior with a mean score of 48.70. The mean score of frailty syndrome was 0.142, categorized in the pre-frail phase. No correlation was found between self-care behavior and frailty syndrome with p=0.20. CONCLUSION: Self-care behavior in elderly patients with heart failure is still inadequate and in the pre-frail phase. Nurses and other health professionals should consider intervention to increase self-care behavior among the elderly and screening to increase their awareness of frailty syndrome.

Quality of life in the COVID-19 outbreak: influence of psychological distress, government strategies, social distancing, and emotional recovery

Considering the severity of the effects of COVID-19 on psychological health and quality of life, the present study investigates the direct effects of government strategies and social distancing and the moderating effect of emotional recovery on psychological distress and quality of life using the tenets of the theory of attachment and learned helplessness. The snowball sampling technique was used to recruit respondents from Bangladesh who completed a self-administered questionnaire via Google Forms, which provided cross-sectional data. The results revealed that both social distancing and government strategies have significant negative influences on psychological distress. Besides, government strategies have a significant positive influence on social distancing. Although psychological distress has a significant negative influence on quality of life, emotional recovery shows no moderating effect on the relationship between psychological distress and quality of life during the COVID-19 pandemic. The study provides insights for regulatory bodies and policymakers for developing effective policy interventions to ensure the well-being of people during this pandemic. Finally, the study highlights the implications for both theory and practice and a few notes for further research.