• Korean Journal of Adult Nursing
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• v.27 no.2
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• pp.242-250
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• 2015

Purpose: To evaluate heart failure knowledge and adherence to self-care behaviors, and to identify factors affecting adherence to self-care behaviors among Korean patients with heart failure. Methods: Correlational research using the European Heart Failure Self-care Behavior Scale, the Duke Activity Status Index, the Dutch Heart Failure Knowledge Scale, the New York Heart Association Functional Classification, and the Medical Outcomes Study Social Support Survey was conducted. A total of 280 outpatients with heart failure responded to the five questionnaires. Results: The mean scores for self-care adherence and heart failure knowledge were $31.98{\pm}6.81$ and $8.78{\pm}2.53$, respectively, indicating lower adherence and knowledge than those previously reported. Subjects with lower functional status, more social supports, and greater knowledge of heart failure are more likely to adhere to prescribed regimens. Conclusion: Nurses should focus on patient education and support to improve their adherence to self-care behaviors.

• Journal of Korean Critical Care Nursing
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• v.6 no.2
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• pp.51-64
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• 2013

Purpose: This study was to analyze adherence to self-care behaviors and identify factors affecting the adherence behaviors among inpatients with heart failure. Methods: A total 94 hospitalized inpatients from three hospitals participated in a survey. Data were collected using structured self-reported questionnaire from November 28, 2011 to March 31, 2013 and analyzed using frequency, t-test, ANOVA, Pearson's correlation coefficients and stepwise multiple regression. Results: The score of adherence to self-care behaviors among inpatients with heart failure was $26.02({\pm}8.84)$. Factors related to the adherence to self-care behaviors were living with spouse (t=-2.47, p=.019), functional state (t=2.18, p=.034), heart failure knowledge (r=-.49, p<.001), social support (r=-.35, p<.001), self-control (r=-.25, p=.016), and self-care confidence (r=-.24, p=.019). The factors affecting adherence to self-care behaviors were heart failure knowledge, self-care confidence, and social support. These factors explained 32% of the variance in adherence to self-care behaviors. Conclusion: The adherence to self-care behaviors with heart failure can be improved if heart failure knowledge, self-care confidence, and social support are improved. Therefore, developing a nursing intervention program for patient with heart failure that is considered these factors leads to improve quality of life and prevent readmission.

• Korean Journal of Adult Nursing
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• v.23 no.3
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• pp.244-254
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• 2011

Purpose: The objective of this study was to evaluate adherence to self-care and identify associated factors in outpatients with Heart Failure (HF). Methods: Using a cross-sectional design, a convenience sample of 249 outpatient clinic patients were recruited at S university hospital. Between October 2009 and December 2009, data were collected through questionnaires and medical record review. Results: The total mean score of adherence to self-care was $18.07{\pm}3.56$ out of a possible 45 points. Among self-care dimensions, adherence to medication and low salt diet was high, while lower adherence was reported in contact with health professionals if symptoms such as weight gain, edema and fatigue were presented. Multivariate analysis adjusted for other socio-demographic and clinical factors showed that disease knowledge related to heart failure (p<.001) and left ventricular ejection fraction (p=.027) were independent predictors of adherence to self-care. These factors explained 23% of total variance in the adherence to self-care. Conclusion: Heart failure patients with higher disease knowledge and those who have good systolic function may be more likely to engage in adherence to self-care than those with lack of disease knowledge and low contractility. Further research is needed to confirm these results and identify other predictors of adherence to self-care.

• Journal of Korean Clinical Nursing Research
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• v.22 no.1
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• pp.28-37
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• 2016

Purpose: This study was to investigate the relationships between among health literacy, knowledge and self-care behavior in elderly patients with heart failure(HF). Methods: 166 patients (age ${\geq}65$ years) with HF were recruited in a cardiovascular center of an university affiliated hospital. The structured questionnaire included Health literacy, Dutch Heart Failure Knowledge Scale, European Heart Failure Self-care Behavior, Self-Care of Heart Failure Index. Data were analyzed by descriptive statistics, Chi-test, Pearson correlation analysis, t-test and ANCOVA using SPSS/WIN version 21.0. Results: Participants with the high level of health literacy were more likely to be younger (p=.001), men (p=.001), with more education (p<.001), and have a job (p=.004), and with a higher economic status (p=.005). The positive correlations between the level of health literacy, knowledge, and self-care behavior were confirmed (p<.001). Participants with the high level of health literacy showed higher level of knowledge, more self-care behavior for health maintenance, and confidence. Conclusion: This study shows that the level of health literacy may influence knowledge and self-care behavior in elderly patients with HF. In order to improve self-care behaviors in elderly patients, a strategic nursing approach based on the level of patients' health literacy needs to be considered.

• Korean Journal of Adult Nursing
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• v.28 no.3
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• pp.302-313
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• 2016

Purpose: The objective of this study was to identify factors related to self-care adherence in symptomatic patients with heart failure (HF). Methods: Using a cross-sectional design, a convenience sample 209 outpatient clinic patients were recruited at two medical centers. Between October 2011 and August 2012, data were collected using the structured questionnaire. Factors related to self-care adherence were examined using hierarchical multiple regression. Results: Mean age of participants was 67.71 years and a half of them (53.6%) were female. They showed relatively low self-care adherence with mean scores of $61.88{\pm}12.92$. Lower self-care adherence was reported in asking for low sodium items, weighing oneself, checking for ankle edema, and exercising for 30 minutes. The overall model significantly explained 23.9% of variance in self-care adherence. Among the predictors, education, New York Heart Association functional classification, and social support were statistically significant in influencing self-care adherence. The variable of negative emotional status such as anxiety and depression were not found to be significant. Conclusion: These findings demonstrate that social support could help self-care adherence among symptomatic patients with HF. Thus, programs targeting self-care adherence in this population should consider the strategies improving social support.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.12 no.2
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• pp.186-194
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• 2005

Purpose: The purpose of this study was to examine self care compliance, family support, and depression in patients with congestive heart failure. Method: The participants were 105 outpatients with congestive heart failure. Data were collected using a questionnaire survey on self care compliance, family support, and depression. The collected data were analyzed using the SPSS Win 10.0 program. Result: 1. The total score for Self care compliance was 78.34 out of a possible 120 and was significantly high for people in ages between 70-79 years and people who were not employed. Exercise compliance was significantly high in men and classifications I & II of the NYHA class. Compliance with smoking and alcohol cessation were significantly high in women. Medication compliance was significantly high in the group which had experience with hospitalization. Family support was 31.75 out of a possible 40 and showed significant differences depending on spouse status and religion. Depression was 30.18 out of a possible 64 and was significantly high in the group whose educational level was above college graduation or who were under 65 years of age. Conclusion: The results suggest that nurses have to emphasize smoking and alcohol cessation for men, exercise for women and total self care compliance for patients under 65 years of age.

• Journal of Digital Convergence
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• v.16 no.9
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• pp.319-327
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• 2018

This study is a qualitative study using focus group interview to explore the perception regarding smartphone use for adhering to self-care in chronic heart failure patients. Eleven patients who were diagnosed with heart failure were included. Three focus groups were held with heart failure patients at an outpatient cardiac care center. The focus group discussions were transcribed verbatim and analyzed using the method of constant comparative analysis. The 12 sub-themes were categorized into 'perception of smartphone use', 'Barriers to smartphone use', and 'Facilitators to smartphone use'. We found that the need to design tailored the messages or health information based on individual preferences. Our findings will be used to develop or design a smartphone based self-care program for patients with heart failure.

• Journal of Korean Critical Care Nursing
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• v.14 no.3
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• pp.113-127
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• 2021

Purpose : This systematic review was conducted to identify which dyadic intervention could be implemented for heart failure patient-family caregiver dyads to improve patient and/or their family caregivers outcomes. Method : Eleven databases were searched from their inception to July, 2021. This review considered any randomized controlled trials that evaluated the effectiveness of intervention including heart failure patient-family caregiver dyads. Two reviewers independently evaluated the methodological quality using the Cochrane Collaboration's tool for assessing risk of bias and extracted details of the included studies. The studies included in this review were not suitable for meta-analysis and therefore the results were presented as a narrative summary. Results : Six studies including 900 dyads were included and mainly primary family caregiver of patients was spouse. Majority of dyadic intervention were focused on psychoeducational intervention excepting one study on mobile health intervention. All studies included in this review focused on patients' outcomes compared to family caregivers' outcomes and dyadic outcomes. Individual interventions improved quality of life among heart failure patients and their family caregivers in two articles. The overall quality of selected articles was low. Conclusions : This study provides moderate support for the use of a dyadic intervention to improve quality of life among heart failure patients and their family caregivers. More rigorous high-quality studies investigating interventions to meet the needs of patient and family caregivers in heart failure care are needed.

• Journal of Korean Academy of Nursing
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• v.46 no.6
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• pp.881-893
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• 2016

Purpose: The purpose of this study was to develop a heart health diary to promote self-care ability among patients with heart failure (HF), and to identify the diary's effect on self-care adherence, self-efficacy, and physical activity. Methods: A randomized control-group pretest-posttest design was adopted using block randomization. A calender-typed health diary was developed and it included a self-care checklist and education information on HF management. The experimental group were given guided counseling and education for 8 weeks and wrote a daily health diary during that period. Data were collected from the outpatient department of a tertiary medical center from February to April 2016. To verify the hypotheses, data for the experimental group (n=28) and control group (n=33) were analysed using the independent t-test with SPSS/WIN 21.0. Results: At the end of 8 weeks the experimental group had significantly higher scores for self-care adherence (t=-2.48, p =.016) and exercise related self-efficacy (t=-3.44, p =.001) compared to the control group. Conclusion: The findings show that the application of a patient-directed heart health diary is an effective nursing intervention for improving HF patients' self-care adherence and exercise self-efficacy. Strategies to promote dietary self-efficacy are necessary along with further studies including repeated research with an increasing intervention period. Healthcare providers need to encourage the utilization of a health diary for HF patients as a tool for evaluation and for implementation that leads to self-care.

• Korean Circulation Journal
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• v.53 no.5
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• pp.294-312
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• 2023

Heart failure (HF) is a global health problem closely related to morbidity and mortality. As the burden of HF increases, it is necessary to manage and treat this condition well. However, there are differences between real-world practice and guidelines for the optimal treatment for HF. Patient-related, healthcare provider-related, and health system-related factors contribute to poor adherence to optimal care. This review article aims to examine HF treatment patterns and treatment adherence in real-world practice, identify clinical gaps to suggest ways to improve the quality of care for HF and clinical outcomes for patients with HF. Although it is important to optimize treatment based on evidence-based guidelines to the greatest extent, it is known that there is still poor treatment adherence, and many patients do not receive guideline-directed medical therapy, especially at the early stages. To improve medication adherence, qualitative evaluation through performance measurement, as well as education of patients, caregivers and medical staff through a multidisciplinary approach are important.