2.50
Hdl Handle:
http://hdl.handle.net/10755/157214
Type:
Presentation
Title:
Heart Failure Self-Management Behaviors in an Indigent Population
Abstract:
Heart Failure Self-Management Behaviors in an Indigent Population
Conference Sponsor:Western Institute of Nursing
Conference Year:2006
Author:O'Connell, Aurelia, PhD, ACNP
P.I. Institution Name:University of California Los Angeles
Title:Assistant Professor
Contact Address:700 Tiverton Avenue, 4-242 Factor Building, Los Angeles, CA, 90095, USA
Contact Telephone:310-794-4338
Purposes/Aims: Heart failure (HF) is a debilitating chronic disease which affects minorities in a disproportionate way. The role of patient self-management (SM) is of increasing importance in HF to improve outcomes. Studies suggest that clinical, socio-economic, and psychosocial variables are related to the performance of SM behaviors. The purposes of this study were to: (1) describe the SM behaviors of indigent persons with HF with specific interest on clinical and psychosocial variables, (2) determine whether demographic, clinical and psychosocial status predict SM behaviors, and (3) determine if gender and racial differences exist. Rationale/Background/Conceptual Framework: Widening disparities in health are becoming apparent as medical care is becoming more complex. It has been suggested that poor health in socioeconomically disadvantaged populations results from unfavorable social conditions and ineffective self-management. The role of patient SM assumes increasing importance especially within chronic disease management since it has been shown to improve the patient?s overall health and well-being, as well as to reduce hospitalizations and costs. However, most of the research that has been done consisted of mostly White male samples. Little is known about the influence of clinical, socio-economic, and psychosocial variables on SM behaviors, especially in groups of different ethnicities and of lower socioeconomic status, and those who are also uninsured or indigent. Methods: This is a cross-sectional study design utilizing a one-time structured interview. Subjects were recruited from three cardiology clinics and one hospital in central California. Subjects were asked a series of questions from the following instruments: (1) a General Health Perception Question, (2) the Self-Efficacy to Perform SM Behaviors instrument, (3) the ENRICHD Social Support Instrument, (4) the Center for Epidemiological Depression (CESD) scale, and (5) the Self-Management in HF questionnaire. Results: The sample consisted of 65 men and women with a mean age of 59ñ14(SD), with a majority with <high school education (57%), unemployed (86%), annual incomes <$10,000 (56%), and uninsured (52%). A majority of the sample rated themselves as having poor health perception (82%), high self-efficacy in performing HF SM behaviors (70%), high social support (83%), and having depressive symptoms (70%). The performance of HF SM behaviors was poor (54%). More Whites and females performed good self-management. Based on multiple regression models, New York Heart Association (NYHA) classification was the only variable to predict the likelihood of performing HF self-management behaviors. Implications: Performance of HF self-management behaviors was poor despite high self efficacy and high social support. Less symptomatic (NYHA class I-II) patients had a greater likelihood of performing SM behaviors. Gender and racial differences were noted in this largely indigent population. While many concerns are shared across different diseases, behaviors, and populations, there may be differences among groups and individuals. The information gathered in this study will provide the ground work for future research to improve self-management behaviors in these minority patients. It is time to expand our research endeavors to racially diverse groups as important contributions to our knowledge in HF.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleHeart Failure Self-Management Behaviors in an Indigent Populationen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157214-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Heart Failure Self-Management Behaviors in an Indigent Population</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">O'Connell, Aurelia, PhD, ACNP</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of California Los Angeles</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">700 Tiverton Avenue, 4-242 Factor Building, Los Angeles, CA, 90095, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">310-794-4338</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">aoconnel@sonnet.ucla.edu</td></tr><tr><td colspan="2" class="item-abstract">Purposes/Aims: Heart failure (HF) is a debilitating chronic disease which affects minorities in a disproportionate way. The role of patient self-management (SM) is of increasing importance in HF to improve outcomes. Studies suggest that clinical, socio-economic, and psychosocial variables are related to the performance of SM behaviors. The purposes of this study were to: (1) describe the SM behaviors of indigent persons with HF with specific interest on clinical and psychosocial variables, (2) determine whether demographic, clinical and psychosocial status predict SM behaviors, and (3) determine if gender and racial differences exist. Rationale/Background/Conceptual Framework: Widening disparities in health are becoming apparent as medical care is becoming more complex. It has been suggested that poor health in socioeconomically disadvantaged populations results from unfavorable social conditions and ineffective self-management. The role of patient SM assumes increasing importance especially within chronic disease management since it has been shown to improve the patient?s overall health and well-being, as well as to reduce hospitalizations and costs. However, most of the research that has been done consisted of mostly White male samples. Little is known about the influence of clinical, socio-economic, and psychosocial variables on SM behaviors, especially in groups of different ethnicities and of lower socioeconomic status, and those who are also uninsured or indigent. Methods: This is a cross-sectional study design utilizing a one-time structured interview. Subjects were recruited from three cardiology clinics and one hospital in central California. Subjects were asked a series of questions from the following instruments: (1) a General Health Perception Question, (2) the Self-Efficacy to Perform SM Behaviors instrument, (3) the ENRICHD Social Support Instrument, (4) the Center for Epidemiological Depression (CESD) scale, and (5) the Self-Management in HF questionnaire. Results: The sample consisted of 65 men and women with a mean age of 59&ntilde;14(SD), with a majority with &lt;high school education (57%), unemployed (86%), annual incomes &lt;$10,000 (56%), and uninsured (52%). A majority of the sample rated themselves as having poor health perception (82%), high self-efficacy in performing HF SM behaviors (70%), high social support (83%), and having depressive symptoms (70%). The performance of HF SM behaviors was poor (54%). More Whites and females performed good self-management. Based on multiple regression models, New York Heart Association (NYHA) classification was the only variable to predict the likelihood of performing HF self-management behaviors. Implications: Performance of HF self-management behaviors was poor despite high self efficacy and high social support. Less symptomatic (NYHA class I-II) patients had a greater likelihood of performing SM behaviors. Gender and racial differences were noted in this largely indigent population. While many concerns are shared across different diseases, behaviors, and populations, there may be differences among groups and individuals. The information gathered in this study will provide the ground work for future research to improve self-management behaviors in these minority patients. It is time to expand our research endeavors to racially diverse groups as important contributions to our knowledge in HF.</td></tr></table>en_GB
dc.date.available2011-10-26T19:40:13Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:40:13Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.