Abstract
Purpose: To describe the level of knowledge and self-care in patients hospitalised due to heart failure (HF).
Methods: A consecutive sample of patients with chronic HF in NYHA II-IV, hospitalised at one university and one county hospital in Sweden were included in the study. Data were collected through questionnaires, interviews and through chart review.
Results: A total of 111 HF patients were included. They had a mean age of 77± 10 years, 41% women and 23% with a higher education than elementary school. Men had significantly better knowledge on self-care than women and the elderly >75 years of age had less knowledge than those under 75 years.
Daily weighing: Forty-seven of the patients stated that they weighed themselves (42%) regularly, defined as once a week or more. In one third of the patients the weight had increased before hospitalisation. 41% of the patients knew the rationale for weighing themselves, the correlation between knowledge and actually performing the behaviour was 0.3 (P<0.001).
Flexible diuretic intake: One out of 5 of the patients had taken extra diuretics before hospitalisation, mean 4.4 times. 23% of the patients knew the rationale for decreasing diuretics and 26% the rationale for increasing. The correlation between knowledge and actually performing the behaviour was 0.42 for both increasing and decreasing diuretics (P<0.001 for both).
Restricted fluid and salt intake: One third of the patients restricted their fluid intake. Before hospitalisation, 32% had increased their fluid intake and 12% had decreased their intake. 47% knew the rationale for restricted fluid intake. The correlation between knowledge and actually performing the behaviour was 0.3 for restricted fluid intake (P<0.01).
86% of the patients stated that they restricted their salt intake, despite that only 37% knew the rationale for that.
Medication: Thirty-two patients (29%) had changed their mediation on their own initiative without consulting their physician during the last months. 45% of the patients knew which drugs they were prescribed due to their heart failure and 27% of the patients could describe how all their drugs worked. Five per cent of the patients took NSAID drugs as pain medication. Only 5% knew the rational for not taking NSAID when having heart failure due to the risk of fluid retention.
Conclusion: Knowledge on self-care and performed self-care behaviour was quite poor in this HF population. The findings underline that elderly heart failure patients need to be targeted with education specially designed for their barriers and needs.