Self-Care and Health-Related Quality of Life Among Heart Failure Patients in Tagus Valley Regional Hospital, Portugal: A Pilot Study

Figures & data

Table 1 Distributions of Socio-Demographic Characteristics of Heart Failure Patients at the Cardiology Unit in Tagus Valley Regional Health Hospital, Portugal, January 2021 (N = 24)

Sociodemographic Variables		Frequency	(%)	Mean (SD)
Age				66.88±12.8
Sex	Male	20	83.3%
	Female	4	16.7%
Marital status	Married	16	66.7%
	Single	3	12.5%
	Widowed	2	8.3%
	Divorced	3	12.5%
Residence	Home	20	83.3%
	Apartment	4	16.7%
Educational status	No formal education	2	8.3%
	Primary education	17	70.85%
	Secondary education	3	12.5%
	Higher education	2	8.3%
Professional activities	Retired	17	70.8%
	Active worker	7	29.2%
Living arrangement	Alone	4	16.7%
	With family/partner	20	83.3%
Duration of illness (HF)	Less 5 years	10	41.7%
	5–10 years	4	16.7%
	More than 10 years	4	16.7%
	Do not remember	6	25%
History of hospitalization	Do not remember	2	8.3%
	No	8	33.3%
	Yes	14	58.3%
Frequency of hospitalization	≤ 2 times	9	64.3%
	>2 times	5	35.7%

Table 2 The Distribution of Clinical Characteristics of Heart Failure Patients at the Cardiology Unit, Tagus Valley Regional Health Hospital, Portugal, January 2021 (N = 24)

Clinical Variable		Frequency	(%)
Etiology	Known	14	58.3%
	Unknown	5	20.8%
	No information	5	20.8%
Specified etiologies of HF	Acute myocardial infarction	4	16.67%
	Valvular heart disease	4	16.67%
	Hypertension	2	8.3%
	Cardiomyopathy	2	8.3%
	Others	2	8.3%
NYHA functional class	Class I	4	17.4%
	Class II	12	52.2%
	Class III	3	13%
	Class IV	4	17.4%
Presence of comorbidities	Yes	22	91.7%
	No	2	8.3%
Types of comorbidities	Ischaemic heart disease	13	54.2%
	Vascular diseases	10	41.7%
	Diabetes	10	41.7%
	Hypertension	16	66.7%
	Obesity	11	45.8%
Mean			SD
Average No. of comorbidities		2.71	1.40
Left ventricular ejection fraction		37	12

Table 3 The Distribution of Self-Care of Heart Failure Index Score and Health-Related Quality of Life

Self-care of Heart Failure Index Score	Range	Mean	SD	Median (IQR)
Self-care maintenance score	(0–100)	47.77	15.28	43.33(37.49–60.83)
Self-care management score	(0–100)	54.38	18.26	55(41.25–70)
Self-care confidence score	(0–100)	70.20	17.64	66.72(61.16–82.01)
Health-Related Quality Of Life
HRQoL Total score	(0–105)	44.00	29.12	43.50(15–66.5)
HRQoL physical dimension score	(0–40)	19.79	12.81	22.50(6–29)
HRQoL emotional dimension score	(0–25)	10.08	8.23	8.50(2.5–16)

Figure 1 The level of health-related quality of life among study participants.

Table 4 Pearson’s r Correlation Coefficients for Variables Associated with Self-Care and Health-Related Quality of Life

Clinical Variables	Self-Care Maintenance	Self-Care Management	Self-Care Confidence	Total HRQoL	Physical Dimension	Emotional Dimension
Age	0.354	−0.138	0.126	0.177	0.257	0.094
Gender (male)	0.016	−0.09	0.122	−0.032	−0.073	−0.162
Marital status (married)	−0.013	0.058	0.303	−0.409*	−0.397	−0.461*
Professional activity (active)	−0.18	0.154	−0.22	−0.086	−0.159	−0.007
Associated disease (yes)	0.35	−0.088	−0.11	0.065	0.044	0.087
Living arrangement (with family)	−0.195	0.041	0.269	−0.275	−0.429*	−0.186
Educational status	−0.154	0.442*	−0.188	−0.016	−0.176	0.122
NYHA functional class	−0.124	−0.197	−0.322	0.219	0.308	0.272
No. of comorbidity	−0.079	−0.314	−0.104	−0.04	0.023	0.025
Ejection fraction	0.325	−0.024	−0.002	0.067	0.037	−0.01
Self-care maintenance	1	0.332	0.227	0.347	0.269	0.412*
Self-care management	0.332	1	0.198	0.251	0.035	0.385
Self-care confidence	0.227	0.198	1	−0.113	−0.192	−0.082
Total HRQoL	0.347	0.251	−0.113	1	0.933**	0.946**
Physical dimension	0.269	0.035	−0.192	0.933**	1	0.825**
Emotional dimension	0.412*	0.385	−0.082	0.946**	0.825**	1

Notes: *Correlation is significant at the 0.05 level (2-tailed). **Correlation is significant at the 0.01 level (2-tailed). The categories in the brackets are reference categories.

Table 5 Multivariate Analysis of Predictors Heart Failure Patient’s Self-Care

Variables	B	Std. Error	Beta	T	p	95.0% CI	Model Statistics
Self-care maintenance
Gender (male)	6.829	8.263	0.17	0.826	0.423	−11.021–24.68	F=2.508 Adjusted R^2= 0.396 p=0.061
Age	0.464	0.247	0.389	1.883	0.082	−0.068–0.997
NYHA (I)
Class II	0.44	7.252	0.015	0.061	0.953	−15.228–16.108
Class III	−18.943	10.711	−0.419	−1.769	0.1	−42.083–4.197
Class IV	−17.365	9.905	−0.433	−1.753	0.103	−38.763–4.034
Attended education	−7.617	10.659	−0.141	−0.715	0.487	−30.644–15.41
Live with family	−4.079	9.047	−0.102	−0.451	0.66	−23.623–15.465
Total HRQoL score	−0.838	0.606	−1.597	−1.382	0.19	−2.148–0.472
Physical dimension score	0.497	0.86	0.417	0.578	0.573	−1.36–2.354
Emotional dimension score	3.159	1.243	1.701	2.542	0.025^a	0.474–5.843
Self-care management
Gender (male)	−19.566	8.988	−0.408	−2.177	0.049^a	−38.984–0.147	F=3.294 Adjusted R^2=0.499 p=0.024
Age	0.082	0.268	0.058	0.307	0.764	−0.497–0.622
NYHA (I)
Class II	−7.663	7.889	−0.214	−0.971	0.349	−24.707–9.381
Class III	−5.583	11.652	−0.103	−0.479	0.64	−30.755–19.59
Class IV	−33.064	10.775	−0.689	−3.069	0.009^a	−56.342—9.786
Attended Education	11.678	11.595	0.181	1.007	0.332	−13.372–36.728
Living with family	−12.634	9.841	−0.263	−1.284	0.222	−33.895–8.627
Total HRQoL score	1.236	0.66	1.971	1.873	0.084	−0.189–2.66
Physical dimension score	−3.008	0.935	−2.111	−3.217	0.007^a	−5.029–0.988
Emotional dimension score	1.019	1.352	0.459	0.754	0.464	−1.901–3.939
Self-care confidence
Gender (male)	14.619	11.665	0.315	1.253	0.232	−10.58–39.819	F=1.248 Adjusted R^2=0.097 p=0.347
Age	0.732	0.348	0.532	2.103	0.055	−0.02–1.484
NYHA (I)
Class II	4.765	10.238	0.138	0.465	0.649	−17.354–26.883
Class III	16.694	15.121	0.32	1.104	0.29	−15.973–49.361
Class IV	−15.884	13.983	−0.343	−1.136	0.276	−46.092–14.325
Attended education	0.888	15.047	0.014	0.059	0.954	−31.619–33.396
Living with family	22.53	12.771	0.486	1.764	0.101	−5.06–50.121
Total HRQoL score	0.366	0.856	0.604	0.427	0.676	−1.484–2.215
Physical dimension score	−1.09	1.214	−0.792	−0.898	0.385	−3.712–1.532
Emotional dimension score	0.425	1.754	0.198	0.242	0.812	−3.365–4.214

Note: ^aP<0.05, The categories in the brackets are reference categories.

Table 6 Multivariate Analysis of Predictors Heart Failure Patients Health-Related Quality of Life

Variables	B	Std. Error	Beta	T	95% CI	p-value	Model
Total HRQoL
Age	0.467	0.751	0.205	0.621	−1.186–2.12	0.547	F=1.382 Adjusted R^2= 0.166 p= 0.300
Gender (male)	19.466	19.958	0.255	0.975	−24.46–63.392	0.35
Married	−32.247	17.613	−0.533	−1.831	−71.012–6.518	0.094
Active worker	−4.536	18.357	−0.072	−0.247	−44.938–35.867	0.809
Comorbidities	−27.449	27.29	−0.266	−1.006	−87.513–32.615	0.336
Live with family	24.748	27.773	0.324	0.891	−36.379–85.876	0.392
NYHA (I)
Class II	5.2	18.525	0.091	0.281	−35.574–45.973	0.784
Class III	41.875	23.558	0.486	1.778	−9.974–93.725	0.103
Class IV	34.387	21.959	0.45	1.566	−13.944–82.719	0.146
Self-care maintenance	0.995	0.579	0.522	1.718	−0.28–2.27	0.114
Self-care management	0.435	0.37	0.273	1.176	−0.379–1.248	0.264
Self-care confidence	−0.364	0.489	−0.221	−0.744	−1.441–0.713	0.472
Physical dimension
Age	0.236	0.345	0.236	0.684	−0.524–0.996	0.508	F=1.189 Adjusted R^2=0.090 p= 0.391
Gender (male)	4.335	9.175	0.129	0.472	−15.858–24.528	0.646
Married	−14.484	8.097	−0.544	−1.789	−32.305–3.336	0.101
Active worker	−2.58	8.439	−0.094	−0.306	−21.153–15.993	0.766
Comorbidities	−15.344	12.545	−0.338	−1.223	−42.956–12.267	0.247
Live with family	7.479	12.767	0.222	0.586	−20.621–35.58	0.57
NYHA (I)
Class II	−0.1	8.516	−0.004	−0.012	−18.844–18.644	0.991
Class III	20.624	10.829	0.544	1.904	−3.212–44.459	0.083
Class IV	8.452	10.095	0.251	0.837	−13.767–30.67	0.42
Self-care maintenance	0.469	0.266	0.56	1.762	−0.117–1.055	0.106
Self-care management	0.028	0.17	0.041	0.167	−0.346–0.402	0.87
Self-care confidence	−0.203	0.225	−0.279	−0.901	−0.698–0.292	0.387
Emotional dimension
Age	0.08	0.159	0.125	0.505	−0.27–0.43	0.624	F=3.183 Adjusted R^2=0.532 p=0.032
Gender (male)	4.634	4.224	0.214	1.097	−4.663–13.932	0.296
Married	−9.996	3.728	−0.585	−2.681	−18.202- −1.791	0.02^a
Active worker	−1.2	3.885	−0.068	−0.309	−9.752–7.351	0.763
Comorbidities	−8.276	5.776	−0.284	−1.433	−20.989–4.438	0.18
Live with family	9.281	5.879	0.429	1.579	−3.658–22.219	0.143
NYHA (I)
Class II	0.671	3.921	0.042	0.171	−7.959–9.302	0.867
Class III	13.023	4.986	0.535	2.612	2.048–23.998	0.024^a
Class IV	11.229	4.648	0.519	2.416	0.999–21.459	0.034^a
Self-care maintenance	0.353	0.123	0.655	2.879	0.083–0.623	0.015^a
Self-care management	0.164	0.078	0.364	2.099	−0.008–0.336	0.06
Self-care confidence	−0.094	0.104	−0.203	−0.912	−0.322–0.133	0.381

Note: ^aP<0.05, The categories in the brackets are reference categories.