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Executive dysfunction is associated with self-care confidence in patients with heart failure
Institution:1. Corporate Education, University of Maryland Capital Region Health, 3001 Hospital Drive, Cheverly, MD 20785-1189, United States of America;2. Professor Emeritus, Virginia Commonwealth University School of Nursing, 1100 East Leigh St., Richmond, VA 23298-0567, United States of America;3. Formerly: Department of Family and Community Medicine, Palliative Care, University of Maryland School of Medicine Baltimore, MD 21201, United States of America.;4. Formerly: University of Maryland Baltimore School of Nursing, Baltimore, MD 21201, United States of America.;3. School of Nursing and Midwifery, Edith Cowan University, Perth, WA, Australia
Abstract:AimTo explore differences in self-care maintenance, management and confidence levels between American heart failure (HF) patients with and without executive dysfunction.BackgroundEvidence indicates some aspect of cognitive impairment is prevalent in up to 75% of the HF patient population. Moreover, cognitive impairment has been identified as a barrier to adequate self-care contributing to poor outcomes. There is limited understanding of the role executive function, a domain of cognitive performance, has on self-care behaviors for patients with HF.MethodThis secondary analysis examined the role of executive function, measured by the Clock Drawing Test (CDT), in relation to self-care measures. The Self Care of Heart Failure Index v6.2 (SCHFI v6.2) was used to measure self-care maintenance, management, and confidence.ResultsParticipants had a mean age of 75.1 ± 12.5 years, identified as male (59.4%), with New York Heart Association (NYHA) class III (57.3%). Executive function impairment was present in 28% of the sample. Comparison of self-care maintenance and management scores between the two groups were not significant. However, participants with executive dysfunction demonstrated an average self-care confidence score of 48.6 ± 23.3, while participants with no executive function impairment demonstrated a higher average self-care confidence score of 61.5 ± 18.4. Differences in self-care confidence scores between the groups were statistically significant (p = .014).ConclusionsHF self-care confidence is considered a moderator of self-care behaviors. Understanding the influence executive function has on self-care confidence may lead to a better understanding of those needing greater support with self-care behaviors.
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