To explore the association between frailty and self-care in older adults with congestive heart failure and analyze their influencing factors. The cross-sectional study was conducted at the department of cardiology of a hospital in China from March 2018 to November 2018. A total of 165 participants were recruited. Frailty and self-care were measured by the Tilburg Frailty Indicator, and the Self-care of Heart Failure Index (V6). The physical, psychological, and social frailty exerted a significant negative association with self-care. Exercise, income, comorbidities, and times of congestive heart failure-related hospitalizations were independent risk factors for frailty; surgical treatment, comorbidities, and income were independent risk factors for self-care. These findings help to fill the need for new approaches to identify the high risk of frailty individuals in the acute care setting for targeted intervention and tailored transitions in care to promote optimal patient quality care and biopsychosocial well-being.
AuldJ. P.MuddJ. O.GelowJ. M.HiattS. O.LeeC. S. (2018). Self-care moderates the relationship between symptoms and health-related quality of life in heart failure. Journal of Cardiovascular Nursing, 33(3), 217–224. https://doi.org/10.1097/JCN.0000000000000447
2.
AustinP. C.SteyerbergE. W. (2015). The number of subjects per variable required in linear regression analyses. Journal of Clinical Epidemiology, 68(6), 627–636. https://doi.org/10.1016/j.jclinepi.2014.12.014
3.
BellumkondaL.TyrrellD.HummelS. L.GoldsteinD. R. (2017). Pathophysiology of heart failure and frailty: A common inflammatory origin?Aging Cell, 16(3), 444–450. https://doi.org/10.1111/acel.12581
4.
BenjaminE. J.ViraniS. S.CallawayC. W.ChamberlainA. M.ChangA. R.ChengS.ChiuveS. E.CushmanM.DellingF. N.DeoR.de FerrantiS. D.FergusonJ. F.FornageM.GillespieC.IsasiC. R.JiménezM. C.JordanL. C.JuddS. E.LacklandD.. . . MuntnerP. (2018). Heart disease and stroke statistics-2018 update: A report from the American Heart Association. Circulation, 137(12), e67–e492. https://doi.org/10.1161/cir.0000000000000558
5.
BennettS. J.HusterG. A.BakerS. L.MilgromL. B.KirchgassnerA.BirtJ.PresslerM. L. (1998). Characterization of the precipitants of hospitalization for heart failure decompensation. American Journal of Critical Care, 7(3), 168–174.
6.
CharlsonM. E.PompeiP.AlesK. L.MacKenzieC. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases, 40(5), 373–383. https://doi.org/10.1016/0021-9681(87)90171-8
7.
ChengY.ShaoY.WeirC. R.ShahR. U.BrayB. E.GarvinJ. H.Zeng-TreitlerQ. (2017). Predicting adverse outcomes in heart failure patients using different frailty status measures. Studies in Health Technology and Informatics, 245, 327–331.
8.
ChenX.MaoG.LengS. X. (2014). Frailty syndrome: An overview. Clinical Interventions in Aging, 9, 433–441. https://doi.org/10.2147/CIA.S45300
CrammJ. M.TwiskJ.NieboerA. P. (2014). Self-management abilities and frailty are important for healthy aging among community-dwelling older people; a cross-sectional study. BMC Geriatrics, 14, 28. https://doi.org/10.1186/1471-2318-14-28
11.
DavisM. R.LeeC. S.CorcoranA.GuptaN.UchmanowiczI.DenfeldQ. E. (2021). Gender differences in the prevalence of frailty in heart failure: A systematic review and meta-analysis. International Journal of Cardiology, 333, 133–140. https://doi.org/10.1016/j.ijcard.2021.02.062
12.
DharmarajanK.RichM. W. (2017). Epidemiology, pathophysiology, and prognosis of heart failure in older adults. Heart Failure Clinics, 13(3), 417–426. https://doi.org/10.1016/j.hfc.2017.02.001
13.
DicksonV. V.BuckH.RiegelB. (2011). A qualitative meta-analysis of heart failure self-care practices among individuals with multiple comorbid conditions. Journal of Cardiac Failure, 17(5), 413–419. https://doi.org/10.1016/j.cardfail.2010.11.011
14.
DongL.LiuN.TianX.QiaoX.GobbensR. J. J.KaneR. L.WangC. (2017). Reliability and validity of the Tilburg Frailty Indicator (TFI) among Chinese community-dwelling older people. Archives of Gerontology and Geriatrics, 73, 21–28. https://doi.org/10.1016/j.archger.2017.07.001
15.
EelesE. M.WhiteS. V.O'MahonyS. M.BayerA. J.HubbardR. E. (2012). The impact of frailty and delirium on mortality in older inpatients. Age and Ageing, 41(3), 412–416. https://doi.org/10.1093/ageing/afs021
16.
FabbriM.Finney RuttenL. J.ManemannS. M.BoydC.WolffJ.ChamberlainA. M.WestonS. A.YostK. J.GriffinJ. M.KillianJ. M.RogerV. L. (2020). Patient-centered communication and outcomes in heart failure. The American Journal of Managed Care, 26(10), 425–430. https://doi.org/10.37765/ajmc.2020.88500
17.
FolsteinM. F.FolsteinS. E.McHughP. R. (1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198. https://doi.org/10.1016/0022-3956(75)90026-6
18.
FreedlandK. E.SkalaJ. A.SteinmeyerB. C.CarneyR. M.RichM. W. (2021). Effects of depression on heart failure self-care. Journal of Cardiac Failure, 27(5), 522–532. https://doi.org/10.1016/j.cardfail.2020.12.015
19.
FungE.HuiE.YangX.LuiL. T.ChengK. F.LiQ.FanY.SahotaD. S.MaB. H. M.LeeJ. S. W.LeeA. P. W.WooJ. (2018). Heart failure and frailty in the community-living elderly population: What the UFO study will tell us. Frontiers in Physiology, 9, 347. https://doi.org/10.3389/fphys.2018.00347
20.
GobbensR. J.van AssenM. A.LuijkxK. G.Wijnen-SponseleeM. T.ScholsJ. M. (2010). The Tilburg Frailty Indicator: Psychometric properties. Journal of the American Medical Directors Association, 11(5), 344–355. https://doi.org/10.1016/j.jamda.2009.11.003
21.
GobbensR. J. J.van AssenM. A. L. M.LuijkxK. G.ScholsJ. M. G. A. (2012). The predictive validity of the Tilburg Frailty Indicator: Disability, health care utilization, and quality of life in a population at risk. The Gerontologist, 52(5), 619–631. https://doi.org/10.1093/geront/gnr135
22.
GravenL. J.GrantJ. S. (2014). Social support and self-care behaviors in individuals with heart failure: An integrative review. International Journal of Nursing Studies, 51(2), 320–333. https://doi.org/10.1016/j.ijnurstu.2013.06.013
23.
HeB.MaY.WangC.JiangM.GengC.ChangX.MaB.HanL. (2019). Prevalence and risk factors for frailty among community-dwelling older people in China: A systematic review and meta-analysis. The Journal of Nutrition Health & Aging, 23(5), 442–450. https://doi.org/10.1007/s12603-019-1179-9
24.
HoogendijkE. O.AfilaloJ.EnsrudK. E.KowalP.OnderG.FriedL. P. (2019). Frailty: Implications for clinical practice and public health. Lancet, 394(10206), 1365–1375. https://doi.org/10.1016/S0140-6736(19)31786-6
25.
JonesC. D.HolmesG. M.DeWaltD. A.ErmanB.BroucksouK.HawkV.CeneC.WuJ. R.PignoneM. (2012). Is adherence to weight monitoring or weight-based diuretic self-adjustment associated with fewer heart failure-related emergency department visits or hospitalizations?Journal of Cardiac Failure, 18(7), 576–584. https://doi.org/10.1016/j.cardfail.2012.05.004
26.
KangX.Dennison HimmelfarbC. R.LiZ.ZhangJ.LvR.GuoJ. (2015). Construct validity of the Chinese version of the Self-care of Heart Failure Index determined using structural equation modeling. Journal of Cardiovascular Nursing, 30(3), 222–228. https://doi.org/10.1097/JCN.0000000000000134
27.
KessingD.DenolletJ.WiddershovenJ.KupperN. (2016). Fatigue and self-care in patients with chronic heart failure. European Journal of Cardiovascular Nursing, 15(5), 337–344. https://doi.org/10.1177/1474515115575834
28.
KessingD.DenolletJ.WiddershovenJ.KupperN. (2017). Self-care and health-related quality of life in chronic heart failure: A longitudinal analysis. European Journal of Cardiovascular Nursing, 16(7), 605–613. https://doi.org/10.1177/1474515117702021
29.
KessingD.DenolletJ.WiddershovenJ.KupperN. (2019). Self-care and pathophysiological function in patients with chronic heart failure. International Journal of Behavioral Medicine, 26(6), 629–644. https://doi.org/10.1007/s12529-019-09822-2
30.
LeeC. S.MoserD. K.LennieT. A.RiegelB. (2011). Event-free survival in adults with heart failure who engage in self-care management. Heart Lung, 40(1), 12–20. https://doi.org/10.1016/j.hrtlng.2009.12.003
31.
LiG.ShenY. C.ChenC. H.ZhaoY. W.LiS. R.LuM. (1989). An epidemiological survey of age-related dementia in an urban area of Beijing. Acta Psychiatrica Scandinavica, 79(6), 557–563. https://doi.org/10.1111/j.1600-0447.1989.tb10303.x
32.
LiG.ShenY. C.ChenC. H.ZhauY. W.LiS. R.LuM. (1991). A three-year follow-up study of age-related dementia in an urban area of Beijing. Acta Psychiatrica Scandinavica, 83(2), 99–104. https://doi.org/10.1111/j.1600-0447.1991.tb07373.x
33.
MarengoniA.VetranoD. L.Manes-GravinaE.BernabeiR.OnderG.PalmerK. (2018). The relationship between COPD and frailty: A systematic review and meta-analysis of observational studies. Chest, 154(1), 21–40. https://doi.org/10.1016/j.chest.2018.02.014
34.
MarengoniA.ZucchelliA.VetranoD. L.AloisiG.BrandiV.CiutanM.PanaitC. L.BernabeiR.OnderG.PalmerK. (2020). Heart failure, frailty, and pre-frailty: A systematic review and meta-analysis of observational studies. International Journal of Cardiology, 316, 161–171. https://doi.org/10.1016/j.ijcard.2020.04.043
35.
McDonaghJ.MartinL.FergusonC.JhaS. R.MacdonaldP. S.DavidsonP. M.NewtonP. J. (2018). Frailty assessment instruments in heart failure: A systematic review. European Journal of Cardiovascular Nursing, 17(1), 23–35. https://doi.org/10.1177/1474515117708888
36.
MlynarskaA.GolbaK. S.MlynarskiR. (2018). Capability for self-care of patients with heart failure. Clinical Interventions in Aging, 13, 1919–1927. https://doi.org/10.2147/CIA.S178393
37.
Müller-TaschT.LöweB.LossnitzerN.FrankensteinL.TägerT.HaassM.KatusH.SchultzJ. H.HerzogW. (2018). Anxiety and self-care behaviour in patients with chronic systolic heart failure: A multivariate model. European Journal of Cardiovascular Nursing, 17(2), 170–177. https://doi.org/10.1177/1474515117722255
38.
PandeyA.KitzmanD.ReevesG. (2019). Frailty Is intertwined with heart failure: Mechanisms, prevalence, prognosis, assessment, and management. JACC Heart Failure, 7(12), 1001–1011. https://doi.org/10.1016/j.jchf.2019.10.005
39.
PaolilloS.ScardoviA. B.CampodonicoJ. (2020). Role of comorbidities in heart failure prognosis Part I: Anaemia, iron deficiency, diabetes, atrial fibrillation. European Journal of Preventive Cardiology, 27(2_suppl), 27–34. https://doi.org/10.1177/2047487320960288
40.
RiegelB.CarlsonB.MoserD. K.SebernM.HicksF. D.RolandV. (2004). Psychometric testing of the self-care of heart failure index. Journal of Cardiac Failure, 10(4), 350–360. https://doi.org/10.1016/j.cardfail.2003.12.001
41.
RiegelB.LeeC. S.DicksonV. V. (2011). Self care in patients with chronic heart failure. Nature Reviews Cardiology, 8(11), 644–654. https://doi.org/10.1038/nrcardio.2011.95
SeidM. A.AbdelaO. A.ZelekeE. G. (2019). Adherence to self-care recommendations and associated factors among adult heart failure patients. From the patients’ point of view. PLoS One, 14(2), e0211768. https://doi.org/10.1371/journal.pone.0211768
44.
SiriwardhanaD. D.HardoonS.RaitG.WeerasingheM. C.WaltersK. R. (2018). Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: A systematic review and meta-analysis. BMJ Open, 8(3), e018195. https://doi.org/10.1136/bmjopen-2017-018195
45.
SnipeliskyD.ChaudhryS. P.StewartG. C. (2019). The many faces of heart failure. Cardiac Electrophysiology Clinics, 11(1), 11–20. https://doi.org/10.1016/j.ccep.2018.11.001
46.
TakanoE.TeranishiT.WatanabeT.OhnoK.KitajiS.SawaS.KanadaY.TobaK.KondoI. (2017). Differences in the effect of exercise interventions between prefrail older adults and older adults without frailty: A pilot study. Geriatrics and Gerontology International, 17(9), 1265–1269. https://doi.org/10.1111/ggi.12853
47.
TanimuraC.MatsumotoH.TokushimaY.YoshimuraJ.TanishimaS.HaginoH. (2018). Self-care agency, lifestyle, and physical condition predict future frailty in community-dwelling older people. Nursing and Health Sciences, 20(1), 31–38. https://doi.org/10.1111/nhs.12376
48.
TawalbehL. I.Al QadireM.AhmadM. M.AloushS.Abu SumaqaY.HalabiM. (2017). Knowledge and self-care behaviors among patients with heart failure in Jordan. Research in Nursing & Health, 40(4), 350–359. https://doi.org/10.1002/nur.21805
UchmanowiczI.LeeC. S.VitaleC.ManulikS.DenfeldQ. E.UchmanowiczB.RosińczukJ.DrozdM.JarochJ.JankowskaE. A. (2020). Frailty and the risk of all-cause mortality and hospitalization in chronic heart failure: A meta-analysis. ESC Heart Failure, 7(6), 3427–3437. https://doi.org/10.1002/ehf2.12827
51.
UchmanowiczI.WleklikM.GobbensR. J. (2015). Frailty syndrome and self-care ability in elderly patients with heart failure. Clinical Interventions in Aging, 10, 871–877. https://doi.org/10.2147/CIA.S83414
52.
von ElmE.AltmanD. G.EggerM.PocockS. J.GøtzscheP. C.VandenbrouckeJ. P. (2007). The strengthening the reporting of observational studies in epidemiology (STROBE)statement: Guidelines for reporting observational studies. Lancet, 370(9596), 1453–1457. https://doi.org/10.1016/s0140-6736(07)61602-x
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