Fivecoat Hayley C, Sayers Steven L, Riegel Barbara
1 Mental Illness Research, Education and Clinical Center, Corporal Michael J Crescenz VA Medical Center, Philadelphia, USA.
2 Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Eur J Cardiovasc Nurs. 2018 Oct;17(7):598-604. doi: 10.1177/1474515118762800. Epub 2018 Mar 13.
Self-care for patients with heart failure includes engaging in behaviours that maintain medical stability and manage problematic symptoms, as well as the confidence in one's ability to carry out such behaviours. Given the social context of self-care behaviours in heart failure, there has been increasing interest in social support as a predictor of self-care.
The goal of the present study was to examine the role of social support in self-care across time for persons with heart failure.
Using data from an observational study of patients with chronic heart failure ( n = 280), we examined the role of three types of support - instrumental support, emotional support and assistance with self-care - in the longitudinal course of self-care maintenance, management and confidence. Self-report questionnaire data were collected at baseline and at three and six months later.
We found that instrumental and emotional support predicted better self-care confidence on average and that self-care confidence improved at a faster rate for those with less instrumental support. Emotional support was positively associated with self-care management and self-care confidence, and assistance with self-care was positively associated with self-care maintenance.
These findings highlight the contribution of social support to self-care in heart failure and provide guidance for future family-based interventions to improve self-care.
心力衰竭患者的自我护理包括采取维持医疗稳定和管理问题症状的行为，以及对自己实施此类行为能力的信心。鉴于心力衰竭患者自我护理行为的社会背景，社会支持作为自我护理的预测因素越来越受到关注。
本研究的目的是探讨社会支持在心力衰竭患者不同时间点自我护理中的作用。
利用一项对慢性心力衰竭患者（n = 280）的观察性研究数据，我们研究了三种支持类型——工具性支持、情感支持和自我护理协助——在自我护理维持、管理和信心的纵向过程中的作用。在基线以及三个月和六个月后收集自我报告问卷数据。
我们发现，工具性支持和情感支持平均而言能预测更好的自我护理信心，且工具性支持较少的患者自我护理信心提升速度更快。情感支持与自我护理管理和自我护理信心呈正相关，自我护理协助与自我护理维持呈正相关。
这些发现突出了社会支持对心力衰竭患者自我护理的贡献，并为未来基于家庭的改善自我护理的干预措施提供了指导。
