Meraz Rebecca, Osteen Kathryn, McGee Jocelyn, Noblitt Paul, Viejo Henry
J Cardiovasc Nurs. 2025;40(3):250-257. doi: 10.1097/JCN.0000000000001131. Epub 2024 Aug 5.
Residence in socioeconomically disadvantaged neighborhoods and individual sociodemographic conditions contribute to worse heart failure (HF) outcomes and may influence HF self-care. However, associations between neighborhood disadvantage, socioeconomic conditions, and HF self-care are unclear.
The purpose of this secondary analysis was to investigate whether neighborhood disadvantage and individual socioeconomic conditions predicted worse HF self-care.
This study was a secondary analysis of baseline data from a mixed-method study of 82 adults with HF. Participant zip codes were assigned a degree of neighborhood disadvantage using the Area Deprivation Index. Those in the top 20% most disadvantaged neighborhoods (Area Deprivation Index ≥ 80) were compared with those in the least disadvantaged neighborhoods. The Self-Care of Heart Failure Index was used to measure self-care maintenance and monitoring. Multiple linear regression was conducted.
Of all participants, 59.8% were male, 59.8% were persons of color, and the mean age was 64.87 years. Residing in a disadvantaged neighborhood and living alone predicted worse HF self-care maintenance and monitoring. Having no college education was also a predictor of worse HF self-care maintenance. Although persons of color were more likely to reside in disadvantaged neighborhoods, race was not associated with HF self-care.
Residing in a disadvantaged neighborhood and living alone may be important risk factors for worse HF self-care. Differences in self-care cannot be attributed solely to the individual sociodemographic determinants of race, gender, age, annual household income, or marital status. More research is needed to understand the connection between neighborhood disadvantage and HF self-care.
居住在社会经济条件不利的社区以及个人的社会人口状况会导致心力衰竭（HF）的预后更差，并可能影响HF的自我护理。然而，社区劣势、社会经济状况与HF自我护理之间的关联尚不清楚。
这项二次分析的目的是调查社区劣势和个人社会经济状况是否预示着更差的HF自我护理。
本研究是对一项针对82名成年HF患者的混合方法研究的基线数据进行的二次分析。使用区域剥夺指数为参与者的邮政编码分配社区劣势程度。将最不利的20%社区（区域剥夺指数≥80）中的参与者与最有利的社区中的参与者进行比较。使用心力衰竭自我护理指数来衡量自我护理维持和监测情况。进行了多元线性回归分析。
在所有参与者中，59.8%为男性，59.8%为有色人种，平均年龄为64.87岁。居住在不利社区和独居预示着更差的HF自我护理维持和监测情况。未接受过大学教育也是HF自我护理维持较差的一个预测因素。尽管有色人种更有可能居住在不利社区，但种族与HF自我护理无关。
居住在不利社区和独居可能是导致更差的HF自我护理的重要风险因素。自我护理的差异不能仅仅归因于种族、性别、年龄、家庭年收入或婚姻状况等个体社会人口决定因素。需要更多的研究来了解社区劣势与HF自我护理之间的联系。
