Self-efficacy mediates the relationship of depressive symptoms and social support with adherence in patients with heart failure

2016 ◽  
Vol 21 (11) ◽  
pp. 2673-2683 ◽  
Author(s):  
Elizabeth G Tovar ◽  
Rebecca L Dekker ◽  
Misook L Chung ◽  
Yevgeniya Gokun ◽  
Debra K Moser ◽  
...  
Keyword(s):  
Heart Failure ◽  
Social Support ◽  
Depressive Symptoms ◽  
Self Efficacy ◽  
Patients With Heart Failure ◽  
Relationship Of ◽  
The Relationship

scholarly journals A moderated moderation of living arrangements and social support on the relationship between depressive symptoms and medication adherence in patients with heart failure

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
R Lindsay-Rahman ◽  
TA Lennie ◽  
DK Moser ◽  
ML Chung
Keyword(s):  
Heart Failure ◽  
Social Support ◽  
Depressive Symptoms ◽  
Medication Adherence ◽  
Living Arrangements ◽  
Perceived Social Support ◽  
Living Arrangement ◽  
Living Alone ◽  
Patients With Heart Failure ◽  
The Relationship

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Nursing Research grant Background Medication adherence is essential to improve health outcomes in patients with heart failure (HF). Depressive symptoms contribute to decrease adherence behaviors. Although social support is helpful to improving medication adherence, perceived social support (PSS) may differ by living arrangement. How social support and living arrangement contribute to the relationship between depressive symptoms and medication adherence is not well understood in patients with heart failure. Purpose The purpose of this study was to determine whether perceived social support and living arrangement moderated the association between depressive symptoms and medication adherence. Methods This was a secondary analysis from outpatients with HF. Depressive symptoms were measured by the Patient Health Questionnaire-9. Perceived social support was assessed using Multidimensional Scale of Perceived Social Support, and patients were grouped into high and low PSS groups using a score of 79, the upper tertile value. Medication adherence was measured objectively by a medication event monitoring system for 3-months. Living arrangement was classified as (1) living with a spouse, (2) living with non-spouse family or friend, or (3) living alone. Moderated moderation analysis was conducted using PROCESS macro (Model 3) in SPSS with 5,000 bootstrap samples. Results Of the total of 208 patients (mean age = 61 ± 11.5 years, 64% male), 60% lived with spouse, 22% lived with non-spousal family or friend, and 26% lived alone. Three-way interaction (depressive symptoms*living arrangement*PSS) was significant (p = 0.0324, Figure 1). The effect of depressive symptoms on medication adherence was only significant for two groups (Figure 2): the living alone group with high PSS (effect = - 4.1855, p = 0.0021), and the living with a non-spousal family group with low PSS (effect = -1.0180, p = 0.0349). For these groups, their depressive symptoms were inversely associated with medication adherence. Conclusions: These results suggest that living arrangement and perceived social support are factors to be considered in medication adherence when planning care for patients with depressive symptoms. Future research is needed to explore whether the combined intervention of improving depressive symptoms and social support focusing on instrumental social support effectively increases medication adherence.

scholarly journals Race Moderates the Relationship Between Perceived Social Support and Self-care Confidence in Patients With Heart Failure

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Lakeshia Cousin ◽  
Andrew Bugajski ◽  
Harleah Buck ◽  
Terry Lennie ◽  
Misook Lee Chung ◽  
...  
Keyword(s):  
Heart Failure ◽  
Social Support ◽  
Perceived Social Support ◽  
Self Care ◽  
Patients With Heart Failure ◽  
The Relationship

scholarly journals Mediation effect of depressive symptoms in the relationship between perceived control and wellbeing in patients with heart failure and their partners

2018 ◽  
Vol 17 (6) ◽  
pp. 527-534 ◽  
Author(s):  
Maria Liljeroos ◽  
Anna Strömberg ◽  
Kristofer Årestedt ◽  
Misook L Chung
Keyword(s):  
Mental Health ◽  
Heart Failure ◽  
Depressive Symptoms ◽  
Health Status ◽  
Perceived Control ◽  
Self Care ◽  
Mental Health Status ◽  
Mediation Effect ◽  
Patients With Heart Failure ◽  
The Relationship

Background: As treatment has improved, patients with heart failure live longer, and the care mostly takes place at home with partners providing the main assistance. Perceived control over heart failure is important in managing self-care activities to maintain health in patients and their family. Depressive symptoms are associated with impaired health status in patients with heart failure and their family. However, there is limited knowledge about how depressive symptoms affect the relationship between health status and perceived control over heart failure in patients with heart failure and their cohabiting partners. Aim: The aim of this study was to examine whether the relationship between perceived control and health status (i.e. mental and physical) was mediated by depressive symptoms in patients with heart failure and their partners. Methods: In this secondary data analysis, we included 132 heart failure patients and 132 partners who completed measures of depressive symptoms (the Beck depression inventory II), perceived control (the control attitude scale), and physical and mental health status (the short form-36) instruments. The mediation effect of depression was examined using a series of multiple regression in patients and their family caregivers separately. Results: We found a mediator effect of depressive symptoms in the relationship between perceived control and mental health status in both patients and partners. The relationship between perceived control and physical health status was mediated by depressive symptoms in the patients, not in the partners. Conclusion: Efforts to improve self-care management and maintenance by targeting perceived control may be more effective if depressive symptoms are also effectively managed.

scholarly journals The types of comorbidities are associated with self-care of heart failure, but not the number of comorbidities

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
KS Lee ◽  
DK Moser ◽  
K Dracup
Keyword(s):  
Heart Failure ◽  
Self Care ◽  
Comorbid Conditions ◽  
Funding Sources ◽  
Patients With Heart Failure ◽  
Comorbidity Index ◽  
Relationship Of ◽  
The Relationship ◽  
Rural Patients ◽  
Care Behavior

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): RO1HL083176 Improving Self-Care Behavior and Outcomes in Rural Patients with Heart Failure Background/Introduction: Patients with heart failure (HF) experience cardiac and non-cardiac related comorbid conditions. Such comorbidities create challenges to successful engagement in self-care of HF because patients are asked to simultaneously perform a variety of recommended self-care activities for HF and their comorbid conditions. It is possible that patients with a greater number of comorbid conditions experience more difficulty performing activities of HF self-care compared to those with a smaller number of comorbid conditions. However, it is also possible that types of comorbid conditions are more important factors influencing self-care of HF. Purpose To explore whether self-care of HF is associated with the number of comorbid conditions or types of comorbid conditions. Methods A total of 589 patients with HF (66 years, 41% female, 65% NYHA III/IV) were included in this study. The number of comorbid conditions was measured using the list of the conditions in the Charlson Comorbidity Index. Types of comorbidities were defined as follows: concordant conditions, sharing overall pathophysiologic risk profiles with HF, and discordant conditions, not being directly related to HF. Patients were categorized into 4 groups: HF patients without comorbidities; those with concordant conditions; those with discordant conditions; and those with both concordant and discordant conditions. Self-care was measured with the European HF self-care behavior scale. A multivariate linear regression was performed to explore the relationship of HF self-care with the number and types of comorbid conditions after adjusting for relevant covariates. Results The number of comorbid conditions was not associated with self-care of HF. However, the types of comorbid conditions were related to self-care of HF after controlling for covariates. Compared to HF patients without comorbidities, patients with both concordant and discordant conditions were more likely to have poorer self-care (β=0.155, 95% CI 0.29-4.09). However, levels of self-care in patients having either concordant or discordant conditions were not different from levels in patients having no comorbid conditions. Conclusion: Patients’ adherence to HF self-care was associated with the types of comorbidities, but not the simple count of comorbidities. Patients who had both concordant and discordant conditions were more likely to perform poor self-care of HF compared to those who had either concordant or discordant conditions or no comorbid conditions. It appears that HF patients with both concordant and discordant conditions experience difficulty integrating HF self-care in relation to a variety of conditions.

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