Cognitive influences on self-care decision making in persons with heart failure

Victoria Vaughan Dickson, Nancy Tkacs, Barbara Riegel

Research output: Contribution to journalArticle

Abstract

Background: Despite advances in management, heart failure is associated with high rates of hospitalization, poor quality of life, and early death. Education intended to improve patients' abilities to care for themselves is an integral component of disease management programs. True self-care requires that patients make decisions about symptoms, but the cognitive deficits documented in 30% to 50% of the heart failure population may make daily decision making challenging. After describing heart failure self-care as a naturalistic decision making process, we explore cognitive deficits known to exist in persons with heart failure. Problems in heart failure self-care are analyzed in relation to neural alterations associated with heart failure. As a neural process, decision making has been traced to regions of the prefrontal cortex, the same areas that are affected by ischemia, infarction, and hypoxemia in heart failure. Resulting deficits in memory, attention, and executive function may impair the perception and interpretation of early symptoms and reasoning and, thereby, delay early treatment implementation. Conclusions: There is compelling evidence that the neural processes critical to decision making are located in the same structures that are affected by heart failure. Because self-care requires the cognitive ability to learn, perceive, interpret, and respond, research is needed to discern how neural deficits affects these abilities, decision-making, and self-care behaviors.

Original languageEnglish (US)
Pages (from-to)424-431
Number of pages8
JournalAmerican Heart Journal
Volume154
Issue number3
DOIs
StatePublished - Sep 2007

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Self Care
Decision Making
Heart Failure
Aptitude
Neurobehavioral Manifestations
Executive Function
Memory Disorders
Disease Management
Prefrontal Cortex
Infarction
Hospitalization
Ischemia
Quality of Life
Education
Research
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Cognitive influences on self-care decision making in persons with heart failure. / Vaughan Dickson, Victoria; Tkacs, Nancy; Riegel, Barbara.

In: American Heart Journal, Vol. 154, No. 3, 09.2007, p. 424-431.

Research output: Contribution to journalArticle

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