Predictors of Adherence to Self-care Behaviour among Patients with Chronic Heart Failure Attending Jimma University Specialized Hospital Chronic Follow up Clinic, South West Ethiopia

Abstract

Background: Appropriate self-care in patients with chronic illnesses such as Heart Failure (HF) is associated with prevention or early detection of health problems, better overall health and quality of life, improved clinical outcomes and reduced healthcare costs. Unfortunately, self-care among patients with heart failure is commonly poor, and patients have considerable difficulties performing self-care. There are no studies that documented the selfcare behaviour of cardiac patients in the study area. The objective of this study was to assess predictors of adherence to self-care behaviour among patient with chronic heart failure attending JUSH chronic follow up Clinic. Methods: This study was conducted at JUSH chronic follow up clinic, from February 3 to March 30, 2012, using cross sectional design employing both quantitative and qualitative methods and a total of 255 outpatients with congested heart failure were completed the questionnaire. The sample size was calculated using a formula to estimate a single population proportion and the data was collected by administering pretested structured questionnaire for quantitative study and in depth interview guide for qualitative study. Result: Out of the total 264 clients, 255 were included in the final analysis and giving a response rate of 96.6 %. Majority of the study subjects 151(59.2%) had poor adherence to self-care behaviour. The result of multivariable analysis also showed that knowledge of CHF, depression, duration of CHF, co-morbidity (hypertension and DM) and medication (being digitalized) were independent predictors of poorer adherence to self-care behaviour. Knowledgeable study subjects had 9.395 times more likely adherent to self-care when compared to study subjects that were illiterate, [(Adjusted OR (95% CI of OR) =9.395(4.014, 21.991)] and CES-Depression scale also indicated significant association [(Adjusted OR (95% CI of OR) =2.142(1.168, 3.928)] with adherence to self-care behaviour. Conclusions and recommendations: The results of this study provided insights into self-care behaviour in patients with CHF. First, patients with CHF did not fully engage in self-care behaviour. Second, important factors including; depression, duration of CHF, co-morbidity (hypertension and DM), medication (digitalize) and knowledge of CHF were identified as the top predictors of self-care behaviour. Therefore, nursing intervention programs regarding knowledge of HF is recommended for enhancing self-care and Self-care strategies should target especially patients with diabetes mellitus, depression and patient with less than one year duration of CHF.