Factors associated with the development of expertise in heart failure self-care

Barbara Riegel, Victoria Vaughan Dickson, Lee R. Goldberg, Janet A. Deatrick

Research output: Contribution to journalArticle

Abstract

Background: Self-care is vital for successful heart failure (HF) management. Mastering self-care is challenging; few patients develop sufficient expertise to avoid repeated hospitalization. OBJECTIVE:: To describe and understand how expertise in HF self-care develops. Methods: Extreme case sampling was used to identify 29 chronic HF patients predominately poor or particularly good in self-care. Using a mixed-methods (qualitative and quantitative) design, participants were interviewed about HF self-care, surveyed to measure factors anticipated to influence self-care, and tested for cognitive functioning. Audiotaped interviews were analyzed using content analysis. Qualitative and quantitative data were combined to produce a multidimensional typology of patients poor, good, or expert in HF self-care. Results: Only 10.3% of the sample was expert in HF self-care. Patients poor in HF self-care had worse cognition, more sleepiness, higher depression, and poorer family functioning. The primary factors distinguishing those good versus expert in self-care were sleepiness and family engagement. Experts had less daytime sleepiness and more support from engaged loved ones who fostered self-care skill development. CONCLUSION:: Engaged supporters can help persons with chronic HF to overcome seemingly insurmountable barriers to self-care. Research is needed to understand the effects of excessive daytime sleepiness on HF self-care.

Original languageEnglish (US)
Pages (from-to)235-243
Number of pages9
JournalNursing Research
Volume56
Issue number4
DOIs
StatePublished - Jul 2007

Fingerprint

Self Care
Heart Failure
Cognition
Hospitalization
Interviews
Depression

Keywords

  • Cognition
  • Family
  • Mixed methods
  • Naturalistic decission making
  • Sleep

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Factors associated with the development of expertise in heart failure self-care. / Riegel, Barbara; Vaughan Dickson, Victoria; Goldberg, Lee R.; Deatrick, Janet A.

In: Nursing Research, Vol. 56, No. 4, 07.2007, p. 235-243.

Research output: Contribution to journalArticle

Riegel, Barbara ; Vaughan Dickson, Victoria ; Goldberg, Lee R. ; Deatrick, Janet A. / Factors associated with the development of expertise in heart failure self-care. In: Nursing Research. 2007 ; Vol. 56, No. 4. pp. 235-243.
@article{58aa8e53e3eb42ed8bfd3e74a71920fd,
title = "Factors associated with the development of expertise in heart failure self-care",
abstract = "Background: Self-care is vital for successful heart failure (HF) management. Mastering self-care is challenging; few patients develop sufficient expertise to avoid repeated hospitalization. OBJECTIVE:: To describe and understand how expertise in HF self-care develops. Methods: Extreme case sampling was used to identify 29 chronic HF patients predominately poor or particularly good in self-care. Using a mixed-methods (qualitative and quantitative) design, participants were interviewed about HF self-care, surveyed to measure factors anticipated to influence self-care, and tested for cognitive functioning. Audiotaped interviews were analyzed using content analysis. Qualitative and quantitative data were combined to produce a multidimensional typology of patients poor, good, or expert in HF self-care. Results: Only 10.3{\%} of the sample was expert in HF self-care. Patients poor in HF self-care had worse cognition, more sleepiness, higher depression, and poorer family functioning. The primary factors distinguishing those good versus expert in self-care were sleepiness and family engagement. Experts had less daytime sleepiness and more support from engaged loved ones who fostered self-care skill development. CONCLUSION:: Engaged supporters can help persons with chronic HF to overcome seemingly insurmountable barriers to self-care. Research is needed to understand the effects of excessive daytime sleepiness on HF self-care.",
keywords = "Cognition, Family, Mixed methods, Naturalistic decission making, Sleep",
author = "Barbara Riegel and {Vaughan Dickson}, Victoria and Goldberg, {Lee R.} and Deatrick, {Janet A.}",
year = "2007",
month = "7",
doi = "10.1097/01.NNR.0000280615.75447.f7",
language = "English (US)",
volume = "56",
pages = "235--243",
journal = "Nursing Research",
issn = "0029-6562",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Factors associated with the development of expertise in heart failure self-care

AU - Riegel, Barbara

AU - Vaughan Dickson, Victoria

AU - Goldberg, Lee R.

AU - Deatrick, Janet A.

PY - 2007/7

Y1 - 2007/7

N2 - Background: Self-care is vital for successful heart failure (HF) management. Mastering self-care is challenging; few patients develop sufficient expertise to avoid repeated hospitalization. OBJECTIVE:: To describe and understand how expertise in HF self-care develops. Methods: Extreme case sampling was used to identify 29 chronic HF patients predominately poor or particularly good in self-care. Using a mixed-methods (qualitative and quantitative) design, participants were interviewed about HF self-care, surveyed to measure factors anticipated to influence self-care, and tested for cognitive functioning. Audiotaped interviews were analyzed using content analysis. Qualitative and quantitative data were combined to produce a multidimensional typology of patients poor, good, or expert in HF self-care. Results: Only 10.3% of the sample was expert in HF self-care. Patients poor in HF self-care had worse cognition, more sleepiness, higher depression, and poorer family functioning. The primary factors distinguishing those good versus expert in self-care were sleepiness and family engagement. Experts had less daytime sleepiness and more support from engaged loved ones who fostered self-care skill development. CONCLUSION:: Engaged supporters can help persons with chronic HF to overcome seemingly insurmountable barriers to self-care. Research is needed to understand the effects of excessive daytime sleepiness on HF self-care.

AB - Background: Self-care is vital for successful heart failure (HF) management. Mastering self-care is challenging; few patients develop sufficient expertise to avoid repeated hospitalization. OBJECTIVE:: To describe and understand how expertise in HF self-care develops. Methods: Extreme case sampling was used to identify 29 chronic HF patients predominately poor or particularly good in self-care. Using a mixed-methods (qualitative and quantitative) design, participants were interviewed about HF self-care, surveyed to measure factors anticipated to influence self-care, and tested for cognitive functioning. Audiotaped interviews were analyzed using content analysis. Qualitative and quantitative data were combined to produce a multidimensional typology of patients poor, good, or expert in HF self-care. Results: Only 10.3% of the sample was expert in HF self-care. Patients poor in HF self-care had worse cognition, more sleepiness, higher depression, and poorer family functioning. The primary factors distinguishing those good versus expert in self-care were sleepiness and family engagement. Experts had less daytime sleepiness and more support from engaged loved ones who fostered self-care skill development. CONCLUSION:: Engaged supporters can help persons with chronic HF to overcome seemingly insurmountable barriers to self-care. Research is needed to understand the effects of excessive daytime sleepiness on HF self-care.

KW - Cognition

KW - Family

KW - Mixed methods

KW - Naturalistic decission making

KW - Sleep

UR - http://www.scopus.com/inward/record.url?scp=34547181907&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34547181907&partnerID=8YFLogxK

U2 - 10.1097/01.NNR.0000280615.75447.f7

DO - 10.1097/01.NNR.0000280615.75447.f7

M3 - Article

VL - 56

SP - 235

EP - 243

JO - Nursing Research

JF - Nursing Research

SN - 0029-6562

IS - 4

ER -