Predictors of Better Self-Care in Patients with Heart Failure after Six Months of Follow-Up Home Visits

This study aimed to examine the predictors of better self-care behavior in patients with heart failure (HF) in a home visiting program. This is a longitudinal study nested in a randomized controlled trial (ISRCTN01213862) in which the home-based educational intervention consisted of a six-month followup that included four home visits by a nurse, interspersed with four telephone calls. The self-care score was measured at baseline and at six months using the Brazilian version of the European Heart Failure Self-Care Behaviour Scale. The associations included eight variables: age, sex, schooling, having received the intervention, social support, income, comorbidities, and symptom severity. A simple linear regression model was developed using significant variables ( ), followed by a multivariate model to determine the predictors of better self-care. One hundred eighty-eight patients completed the study. A better self-care behavior was associated with patients who received intervention ( ), had more years of schooling ( ), and had more comorbidities ( ). Having received the intervention ( ) and having a greater number of comorbidities ( ) were predictors of better self-care. In the multivariate regression model, being in the intervention group and having more comorbidities were a predictor of better self-care. 1. Introduction Self-care in heart failure (HF) is defined as positive behaviors leading to decisions and actions that an individual can take to help maintain clinical stability and cope with the disease [1]. Studies indicate that the inability of patients to recognize signs and symptoms of congestive episodes and the lack of knowledge and poor adherence to treatment, components that are considered self-care measures, are precipitating factors leading to decompensation of HF [2–5]. Within this context, all self-care behaviors appear to be directly related to motivation, habits, and sociodemographic and clinical characteristics, factors that may affect the way individuals live their lives [1, 6–8]. In this sense, the home environment has gained attention as a potential setting for the development of education strategies and followup of patients with HF, as well as for the investigation of the benefits of such strategies and their effect on self-care behaviors [9–11]. Jaarsma et al. [9], in one of the first published studies on the topic, tested in a randomized controlled trial (RCT) the effect of an education strategy on self-care initiated during hospitalization, followed by a telephone call and a home visit within 10 days after hospital discharge. In