Background: Cognitive impairment can reduce the self-care abilities of heart failure patients. Theory and preliminary evidence suggest that self-care confidence may mediate the relationship between cognition and self-care, but further study is needed to validate this finding. Objectives: The aim of this study was to test the mediating role of self-care confidence between specific cognitive domains and heart failure self-care. Design: Secondary analysis of data from a descriptive study. Settings: Three out-patient sites in Pennsylvania and Delaware, USA. Participants: A sample of 280 adults with chronic heart failure, 62 years old on average and mostly male (64.3%). Methods: Data on heart failure self-care and self-care confidence were collected with the Self-Care of Heart Failure Index 6.2. Data on cognition were collected by trained research assistants using a neuropsychological test battery measuring simple and complex attention, processing speed, working memory, and short-term memory. Sociodemo- graphic data were collected by self-report. Clinical information was abstracted from the medical record. Mediation analysis was performed with structural equation modeling and indirect effects were evaluated with bootstrapping. Results: Most participants had at least 1 impaired cognitive domain. In mediation models, self-care confidence consistently influenced self-care and totally mediated the relation- ship between simple attention and self-care and between working memory and self-care (comparative fit index range: .929–.968; root mean squared error of approximation range: .032–.052). Except for short-term memory, which had a direct effect on self-care maintenance, the other cognitive domains were unrelated to self-care. Conclusions: Self-care confidence appears to be an important factor influencing heart failure self-care even in patients with impaired cognition. As few studies have successfully improved cognition, interventions addressing confidence should be considered as a way to improve self-care in this population.
Vellone, E., Pancani, L., Greco, A., Steca, P., & Riegel, B. (2016). Self-care confidence may be more important than cognition to influence self-care behaviors in adults with heart failure: Testing a mediation model. INTERNATIONAL JOURNAL OF NURSING STUDIES, 60, 191-199 [10.1016/j.ijnurstu.2016.04.016].
|Tipologia:||Articolo su rivista|
|Citazione:||Vellone, E., Pancani, L., Greco, A., Steca, P., & Riegel, B. (2016). Self-care confidence may be more important than cognition to influence self-care behaviors in adults with heart failure: Testing a mediation model. INTERNATIONAL JOURNAL OF NURSING STUDIES, 60, 191-199 [10.1016/j.ijnurstu.2016.04.016].|
|IF:||Con Impact Factor ISI|
|Settore Scientifico Disciplinare:||Settore MED/45 - Scienze Infermieristiche Generali, Cliniche e Pediatriche|
|Revisione (peer review):||Esperti anonimi|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.ijnurstu.2016.04.016|
|Stato di pubblicazione:||Pubblicato|
|Data di pubblicazione:||2016|
|Titolo:||Self-care confidence may be more important than cognition to influence self-care behaviors in adults with heart failure: Testing a mediation model|
|Autori:||Vellone, E; Pancani, L; Greco, A; Steca, P; Riegel, B|
|Appare nelle tipologie:||01 - Articolo su rivista|
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