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Cognitive deficits and self-care behaviors in elderly adults with heart failure

Authors Uchmanowicz I, Jankowska-Polańska B, Mazur G, Sivarajan Froelicher E

Received 24 April 2017

Accepted for publication 22 July 2017

Published 3 October 2017 Volume 2017:12 Pages 1565—1572

DOI https://doi.org/10.2147/CIA.S140309

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 3

Editor who approved publication: Dr Richard Walker


Izabella Uchmanowicz,1 Beata Jankowska-Polańska,1 Grzegorz Mazur,2 Erika Sivarajan Froelicher3,4

1Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland; 2Department and Clinic of Internal and Occupational Diseases and Hypertension, Wroclaw Medical University, Wroclaw, Poland; 3Department of Physiological Nursing, School of Nursing; 4Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco, CA, USA

Introduction:
Elderly adults with heart failure (HF) may have problems with self-care behaviors because of cognitive deficits. Self-care deficits have been found to be significantly associated with negative health care outcomes among HF patients. The aim of this paper was to assess cognitive deficits and the level of self-care ability in elderly patients with HF, and to determine if a relationship exists between cognitive deficits and self-care.
Materials and methods: The study included 270 elderly patients (mean age: 72.5 years) with HF. We used the Mini Mental State Examination Scale (MMSE) to evaluate cognitive functioning, and the European Heart Failure Self-care Behavior Scale, revised into a nine-item scale (EHFScBS-9), to evaluate self-care behaviors. Associations between the variables were examined using multiple regression analysis.
Results: Lower scores in both MMSE and EHFScBS-9 questionnaires were correlated with older age, living alone, lower education, longer duration of illness, higher number of rehospitalizations, as well as lower left ventricular ejection fraction and higher New York Heart Association (NYHA) class. The multiple regression analysis was used for evaluation of the impact of the following predictors: MMSE score, age, duration of illness, ejection fraction, number of hospitalizations, sex, residence, education, relationship status, and NYHA class on EHFScBS-9 score.
Conclusions: Elderly patients with HF may have worse self-care behaviors because of their cognitive deficits. Age was the strongest predictor of worse MMSE scores. Multidisciplinary health teams should pay attention to the special needs of elderly patients who live with their illness for many years and have no social support because of living alone.

Keywords: self-care behaviors, aging care

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