Determinants of self-care decision-making in hospitalised patients with heart failure

Aims and objectives: To explore the important determinants of self-care decision-making in inpatients with heart failure. Background: Self-care is a natural decision-making process that helps patients to improve clinical outcomes. However, patients with heart failure engage in insufficient self-care. More research studies are needed to identify the determinants of self-care decision-making. Design: A cross-sectional correlational research design. Methods: A questionnaire survey with a non-probability sampling was used. A total of 71 inpatients were interviewed at a medical centre in southern Taiwan. Instruments included a demographic and clinical questionnaire, the Dutch Heart Failure Knowledge Scale and the Self-Care of Heart Failure Index. Results: Admission frequency was the only significant determinant of self-care maintenance. Heart failure knowledge, admission frequency and type of residence were important determinants of self-care management. Heart failure knowledge, having a spouse and admission frequency were important determinants of self-care confidence. Conclusions: The study findings support the presence of ongoing clinical challenges associated with poor heart failure knowledge and improper performance of self-care in patients. Admission frequency was correlated with three self-care variables, while heart failure knowledge was associated with self-care management and self-care confidence. Relevance to clinical practice: More effective strategies, including pre-discharge education, consultation of successful cases, case sharing and patient support groups, should be designed to enhance patients' self-care decision-making. However, clinical nurses may not be able to actually perform this task or provide consultation services after hospital discharge due to their workload. Establishment of heart disease educators and professional consultation services may be helpful to improve patient education.