Date of Award

2011

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Nursing

Abstract

Background: Patients with heart failure (HF) are required to participate in self-care activities. This activities include taking prescribed medications, monitoring for symptoms, intervening appropriately and evaluating the response to the treatment. Cognitive impairment occurs relatively frequently in this population. Few studies have attempted to describe the nature of the relationship between self-care and cognitive impairment in this population.

Purpose:/ This study investigated the relationship between cognitive function and self-care ability in patients with HF. It also investigated the relationship between both self-care and cognitive function and subsequent hospital admission.

Methods:/ Participants were recruited from outpatient areas at two cardiology groups specializing in the management of patients with HF. Study variables were assessed at a single visit. Participants were contacted 90 days after study visit to ascertain admission.

Measurements:/ The Self-care in Heart Failure Index, the Repeatable Battery for the Assessment of Neuropsychological Status, the Anosgonosia Questionnaire-Dementia and the Controlled Oral Word Association, as well as a number of demographic variables were used.

Analysis:/ SPSS version 19 was used to perform the statistical analysis. Spearman's correlations and hierarchical multiple regression was used to assess the relationship between variables.

Results:/ The prevalence of cognitive impairment was relatively high in the study group. Similarly, the prevalence of inadequate self-care ability was also high in the study group. Cognitive measures were moderately correlated to each other, but not to the Self-care in Heart Failure Index subscales. Regression analysis demonstrated that only immediate memory predicted self confidence scores when adjusted for loneliness, and minority status.

Conclusion:/ This study failed to demonstrate the proposed relationships. Cognitive impairment is a common finding in patients with HF. Most participants endorsed poor self-care ability.

Implications for Nursing Practice:/ Nurses need to be attuned to evidence of cognitive dysfunction in patients with HF. For any patient demonstrating cognitive dysfunction, independent verification of self-reported symptoms or response to therapy should be obtained.

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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