Title: Supportive relationships, self-care confidence, and heart failure self-care behaviors
Chantira Chiaranai1, PhD, RN, Jeanne Salyer2, PhD, RN, Christine M. Schubert3, PhD
1Suranaree University of Technology, Thailand
2VCU School of Nursing
3Air Force Institute of Technology
Background: The Theory of Heart Failure (HF) Self-care proposes that confidence mediates relationships between social support and self-care behaviors.
Objective: To examine the effects of supportive relationships on self-care behaviors and the mediating effects of self-care confidence in HF outpatients.
Methods: Structural equation modeling (SEM) (SASv9.1) was used to examine the influence of supportive relationships and self-care confidence on self-care management and maintenance in a cross-section of patients with HF (n=97; age=56; 57% male; 45% African American; 55% married). Models included three variables characterizing supportive relationships: marital status (1=currently married; 0= not currently married), social network size (number of persons available to provide support), and perceived social support (Medical Outcomes Study Social Support Scale). The Self-Care of Heart Failure Index (v.4) was used to measure self-care confidence, self-care management, and self-care maintenance. A consensus of fit indices estimated overall model fit. Modified models were estimated after removal of non-significant relationships.
Results: Modified models fit the data well. The indirect effect of social support through self-care confidence on self-care management, in the absence of a significant direct effect, supports the hypothesis that self-care confidence mediates the relationship between social support and self-care management. Self-care confidence was the best predictor of self-care management. In the self-care maintenance model, the direct and indirect effects of self-care confidence attenuated negative effects of social network size. Social support was the best predictor of self-care maintenance.
Conclusions: Findings support the influence of social support on self-care confidence. Self-care confidence mediates the relationship between social support and self-care management and maintenance. Using SEM, we demonstrated that supportive relationships differ in their effects on self-care maintenance vs self-care management.
Audience Take Away:
- Findings support the influence of social support on self-care confidence.
- We demonstrated that self-care confidence mediates the relationship between social support and both self-care management and self-care maintenance.
- Other valuable information provided by our findings is that, using the structural equation modeling approach, we were able to demonstrate that supportive relationships differ in their effects on self-care maintenance versus self-care management and offer an opportunity to consider options for enhancing self-care confidence by improving the quality of social support.
Dr. Chantira Chiaranai graduated doctoral in Nursing from School of Nursing, Virginia Commonwealth University. Her program of research is on self-care in patients with heart failure. Her short term goal is to develop a program of research include; (1) integrating current knowledge of adult health and research methodology; (2) expand the use of self-care in chronically ill patients; and (3) build and develop an international network within her area of research. Her long term goals are to represent nurses at the international level and to manage nursing education, service, and resources to improve the quality of care and improve patient outcomes.