Social Support is Important, but Self-Care Confidence is the Key for Better Treatment Adherence in Patients With Chronic Heart Failure Admitted With an Acute Exacerbation

Introduction: Adherence to treatment is crucial to improve outcomes in patients with heart failure (HF). Social support is associated with adherence, but the mechanism of this association is not well-explored. The purpose of this study was to examine whether self-care confidence mediates the relationship between social support and treatment adherence in patients admitted for acute exacerbation of HF symptoms.Methods: A total of 154 inpatients with HF recruited from two hospitals (62.8 ± 14 years, 51% female, 67% NYHA class III/IV) completed the Self-Care of Heart Failure Index to measure self-care confidence. Social support was measured by the Multidimensional Perceived Social Support Scale. Adherence to low salt diet, exercise and medication was measured using the Medical Outcomes Study Specific Adherence Scale. Clinical and demographic data were collected during patient interview. A series of regression models were used to determine mediation based on the Baron and Kenny method.Results: Controlling for marital status and hospital site, social support was associated with adherence (p= 0.03). When including, self-confidence, the effect of social support was reduced and became non-significant, indicating full mediation. The indirect effect (0.04) of social support on adherence through self-confidence was significant (95% CI= 0.01 - 0.09).Conclusion: HF self-care confidence mediated the relationship between social support and treatment adherence. This suggests that interventions targeting patients’ self-care confidence is essential to maximize patients’ adherence to their treatment regime

Social Support is Important, but Self-Care Confidence is the Key for Better Treatment Adherence in Patients With Chronic Heart Failure Admitted With an Acute Exacerbation

Introduction: Adherence to treatment is crucial to improve outcomes in patients with heart failure (HF). Social support is associated with adherence, but the mechanism of this association is not well-explored. The purpose of this study was to examine whether self-care confidence mediates the relationship between social support and treatment adherence in patients admitted for acute exacerbation of HF symptoms.Methods: A total of 154 inpatients with HF recruited from two hospitals (62.8 ± 14 years, 51% female, 67% NYHA class III/IV) completed the Self-Care of Heart Failure Index to measure self-care confidence. Social support was measured by the Multidimensional Perceived Social Support Scale. Adherence to low salt diet, exercise and medication was measured using the Medical Outcomes Study Specific Adherence Scale. Clinical and demographic data were collected during patient interview. A series of regression models were used to determine mediation based on the Baron and Kenny method.Results: Controlling for marital status and hospital site, social support was associated with adherence (p= 0.03). When including, self-confidence, the effect of social support was reduced and became non-significant, indicating full mediation. The indirect effect (0.04) of social support on adherence through self-confidence was significant (95% CI= 0.01 - 0.09).Conclusion: HF self-care confidence mediated the relationship between social support and treatment adherence. This suggests that interventions targeting patients’ self-care confidence is essential to maximize patients’ adherence to their treatment regime

Impact of Mother-Daughter Relationship on Hypertension Self-management and Quality of Life: Testing Dyadic Dynamics Using the Actor-Partner Interdependence Model

Background: Although hypertension (HTN) treatment rates are similar across age groups of women, effective control is significantly worse among older women. Only 20% of hypertensive women aged 70 to 79 years have controlled blood pressure. Objectives: The purpose of this longitudinal study was to test the effects of the quality of mother-daughter relationship, inner strength, and control on HTN self-management and health-related quality of life (HRQOL) for both members of the dyad at 6 months. The Actor-Partner Interdependence Model was used to examine the direct ( actor ) and indirect ( partner ) effects of 46 dyads. Results: The mothers\u27 perceived relationship quality with daughters directly impacted their own self-management of HTN and HRQOL while also indirectly affecting their daughters\u27 self-management. Similarly, the daughters\u27 perceived strength of their relationship with their mothers directly influenced their self-management and HRQOL and indirectly affected their mothers\u27 self-management and HRQOL

Impact of Mother-Daughter Relationship on Hypertension Self-management and Quality of Life: Testing Dyadic Dynamics Using the Actor-Partner Interdependence Model

Background: Although hypertension (HTN) treatment rates are similar across age groups of women, effective control is significantly worse among older women. Only 20% of hypertensive women aged 70 to 79 years have controlled blood pressure. Objectives: The purpose of this longitudinal study was to test the effects of the quality of mother-daughter relationship, inner strength, and control on HTN self-management and health-related quality of life (HRQOL) for both members of the dyad at 6 months. The Actor-Partner Interdependence Model was used to examine the direct ( actor ) and indirect ( partner ) effects of 46 dyads. Results: The mothers\u27 perceived relationship quality with daughters directly impacted their own self-management of HTN and HRQOL while also indirectly affecting their daughters\u27 self-management. Similarly, the daughters\u27 perceived strength of their relationship with their mothers directly influenced their self-management and HRQOL and indirectly affected their mothers\u27 self-management and HRQOL

Beyond Social Support: Self-Care Confidence Is Key for Adherence in Patients With Heart Failure

Background: Adherence to treatment is crucial to improve outcomes in patients with heart failure. Good social support is associated with better adherence, but the mechanism for this association has not been well-explored. Aims: The aim of this secondary analysis was to examine whether self-care confidence mediates the relationship between social support and treatment adherence in heart failure patients hospitalized with acute exacerbation. Methods: A total of 157 inpatients with heart failure (63.5±13 years, 73% New York Heart Association class III/IV) were recruited from two hospitals located in urban areas in the USA. Participants completed the Self-Care of Heart Failure Index, the Multidimensional Perceived Social Support Scale, and the Medical Outcomes Study Specific Adherence Scale. A series of regression models were used to determine the mediation relationship. Results: Controlling for marital status and hospital site, social support was associated with adherence (p=0.03). When self-confidence was included in the model, the effect of social support became non-significant, indicating full mediation of the relationship between social support and adherence by self-care confidence. The indirect effect (0.04) of social support on adherence through self-confidence was significant (95% confidence interval: 0.01-0.09). Conclusion: Heart failure self-care confidence mediated the relationship between social support and treatment adherence. Thus interventions targeting patients\u27 self-care confidence is essential to maximize patients\u27 treatment adherence

Beyond Social Support: Self-Care Confidence Is Key for Adherence in Patients With Heart Failure

Background: Adherence to treatment is crucial to improve outcomes in patients with heart failure. Good social support is associated with better adherence, but the mechanism for this association has not been well-explored. Aims: The aim of this secondary analysis was to examine whether self-care confidence mediates the relationship between social support and treatment adherence in heart failure patients hospitalized with acute exacerbation. Methods: A total of 157 inpatients with heart failure (63.5±13 years, 73% New York Heart Association class III/IV) were recruited from two hospitals located in urban areas in the USA. Participants completed the Self-Care of Heart Failure Index, the Multidimensional Perceived Social Support Scale, and the Medical Outcomes Study Specific Adherence Scale. A series of regression models were used to determine the mediation relationship. Results: Controlling for marital status and hospital site, social support was associated with adherence (p=0.03). When self-confidence was included in the model, the effect of social support became non-significant, indicating full mediation of the relationship between social support and adherence by self-care confidence. The indirect effect (0.04) of social support on adherence through self-confidence was significant (95% confidence interval: 0.01-0.09). Conclusion: Heart failure self-care confidence mediated the relationship between social support and treatment adherence. Thus interventions targeting patients\u27 self-care confidence is essential to maximize patients\u27 treatment adherence