BACKGROUND: Most heart failure (HF) patients have other comorbid conditions. HF self-care requires medication and diet adherence, daily weight monitoring, and a thoughtful response to symptoms when they occur. Self-care is complicated when other chronic conditions have additional self-care requirements. The purpose of this study is to explore how comorbidity influences HF self-care. METHODS: Using qualitative descriptive meta-analysis techniques, transcripts from 3 mixed methods studies (n = 99) were reexamined to yield themes about perceptions about HF and self-care and to explore the influence on HF self-care. The Charlson Comorbidity Index identified comorbid conditions. RESULTS: The sample was 74% Caucasian, 66% male (mean age of 59.6 years ± 15 years). Fifty-three percent of the sample was New York Heart Association Class III. All had at least 1 other chronic condition. Narrative accounts revealed that adherence to diet, symptom monitoring, and differentiating symptoms from multiple conditions were the most challenging self-care skills. Emerging themes included 1) attitudes drive self-care prioritization and 2) fragmented self-care instruction leads to poor self-care integration and self-care skill deficits. CONCLUSIONS: Individuals with multiple chronic conditions are vulnerable to poor self-care. Research testing coaching interventions that integrate self-care requirements and focus on developing skill in self-care across multiple chronic conditions is needed.
BACKGROUND: Most heart failure (HF) patients have other comorbid conditions. HF self-care requires medication and diet adherence, daily weight monitoring, and a thoughtful response to symptoms when they occur. Self-care is complicated when other chronic conditions have additional self-care requirements. The purpose of this study is to explore how comorbidity influences HF self-care. METHODS: Using qualitative descriptive meta-analysis techniques, transcripts from 3 mixed methods studies (n = 99) were reexamined to yield themes about perceptions about HF and self-care and to explore the influence on HF self-care. The Charlson Comorbidity Index identified comorbid conditions. RESULTS: The sample was 74% Caucasian, 66% male (mean age of 59.6 years ± 15 years). Fifty-three percent of the sample was New York Heart Association Class III. All had at least 1 other chronic condition. Narrative accounts revealed that adherence to diet, symptom monitoring, and differentiating symptoms from multiple conditions were the most challenging self-care skills. Emerging themes included 1) attitudes drive self-care prioritization and 2) fragmented self-care instruction leads to poor self-care integration and self-care skill deficits. CONCLUSIONS: Individuals with multiple chronic conditions are vulnerable to poor self-care. Research testing coaching interventions that integrate self-care requirements and focus on developing skill in self-care across multiple chronic conditions is needed.
Authors: Julie T Bidwell; Ercole Vellone; Karen S Lyons; Fabio D'Agostino; Barbara Riegel; Raúl Juárez-Vela; Shirin O Hiatt; Rosaria Alvaro; Christopher S Lee Journal: Res Nurs Health Date: 2015-08-20 Impact factor: 2.228
Authors: Barbara Riegel; Victoria Vaughan Dickson; Christopher S Lee; Marguerite Daus; Julia Hill; Elliane Irani; Solim Lee; Joyce W Wald; Stephen T Moelter; Lisa Rathman; Megan Streur; Foster Osei Baah; Linda Ruppert; Daniel R Schwartz; Alfred Bove Journal: Heart Lung Date: 2018-01-03 Impact factor: 2.210
Authors: Debra K Moser; Victoria Dickson; Tiny Jaarsma; Christopher Lee; Anna Stromberg; Barbara Riegel Journal: Curr Cardiol Rep Date: 2012-06 Impact factor: 2.931