Self-Care Confidence Mediates the Relationship Between Perceived Social Support and Self-Care Maintenance in Adults With Heart Failure

Social support may be associated with HF self-care; however, the mechanisms are not well understood. We examine the association between perceived support and self-care behaviors and whether self-care confidence mediates these relationships

A single-item self-report medication adherence question predicts hospitalisation and death in patients with heart failure

To determine whether a single-item self-report medication adherence question predicts hospitalization and death in patients with heart failure (HF)

Self-Care Confidence Mediates the Relationship Between Perceived Social Support and Self-Care Maintenance in Adults With Heart Failure

BACKGROUND: Social support may be associated with HF self-care; however, the mechanisms are not well understood. We examine the association between perceived support and self-care behaviors and whether self-care confidence mediates these relationships. METHODS: Cross-sectional survey of HF patients seen in outpatient clinic settings. Our outcome (HF self-care maintenance and self-care management) and mediator (HF self-care confidence) variables were assessed using the Self-Care of Heart Failure Index. Perceived emotional/informational support assessed using the Medical Outcomes Study social support survey. We performed regression analyses to examine associations between perceived support and HF self-care behaviors. Mediation analysis was performed according to Baron & Kenny method. RESULTS: We surveyed 150 HF patients (mean age 61 yrs; 51% female; 43% African Americans). More emotional/informational support was associated with better self-care maintenance (β=0.13, p=0.04). More emotional/information support was associated with better self-care management (β= 0.23, p=0.04) in unadjusted, but not adjusted analysis (β= 0.20, p=0.10). Self-care confidence mediates the association between perceived support and self-care maintenance (percent change in β coefficient was 32%) and management (percent change in β coefficient was 20%). CONCLUSION: Perceived emotional/informational support is associated with better self-care maintenance and possibly better self-care management. Greater self-care confidence is one mediating mechanism

An Absolute Risk Model to Identify Individuals at Elevated Risk for Pancreatic Cancer in the General Population

Purpose We developed an absolute risk model to identify individuals in the general population at elevated risk of pancreatic cancer. Patients and Methods Using data on 3,349 cases and 3,654 controls from the PanScan Consortium, we developed a relative risk model for men and women of European ancestry based on non-genetic and genetic risk factors for pancreatic cancer. We estimated absolute risks based on these relative risks and population incidence rates. Results Our risk model included current smoking (multivariable adjusted odds ratio (OR) and 95% confidence interval: 2.20 [1.84–2.62]), heavy alcohol use (>3 drinks/day) (OR: 1.45 [1.19–1.76]), obesity (body mass index >30 kg/m2) (OR: 1.26 [1.09–1.45]), diabetes >3 years (nested case-control OR: 1.57 [1.13–2.18], case-control OR: 1.80 [1.40–2.32]), family history of pancreatic cancer (OR: 1.60 [1.20–2.12]), non-O ABO genotype (AO vs. OO genotype) (OR: 1.23 [1.10–1.37]) to (BB vs. OO genotype) (OR 1.58 [0.97–2.59]), rs3790844(chr1q32.1) (OR: 1.29 [1.19–1.40]), rs401681(5p15.33) (OR: 1.18 [1.10–1.26]) and rs9543325(13q22.1) (OR: 1.27 [1.18–1.36]). The areas under the ROC curve for risk models including only non-genetic factors, only genetic factors, and both non-genetic and genetic factors were 58%, 57% and 61%, respectively. We estimate that fewer than 3/1,000 U.S. non-Hispanic whites have more than a 5% predicted lifetime absolute risk. Conclusion Although absolute risk modeling using established risk factors may help to identify a group of individuals at higher than average risk of pancreatic cancer, the immediate clinical utility of our model is limited. However, a risk model can increase awareness of the various risk factors for pancreatic cancer, including modifiable behaviors