Confidence in self-care after heart failure hospitalization

Background: Understanding patient perspectives of self-care is critical for improving multidisciplinary education programs and adherence to such programs. However, perspectives of self-care for patients with heart failure (HF) as well as the association between patient perspectives and patient-physician communication remain unclear.Methods: Confidence levels regarding self-care behaviors (eight lifestyle behaviors and four consulting behav-iors) and self-monitoring were assessed using a self-administered questionnaire survey, which was directly dis-tributed by dedicated physicians and nurses to consecutive patients hospitalized with HF in a tertiary-level hospital. Patient-physician communication was evaluated according to the quality of physician-provided infor-mation regarding "treatment and treatment choices" and "prognosis" using the Prognosis and Treatment Percep-tion Questionnaire. Out of 202 patients, 187 (92.6 %) agreed to participate, and 176 completed the survey [valid response rate, 87.1 %; male, 67.0 %; median age, 73 (63-81) years]. Multivariate logistic regression analyses were conducted to predict low confidence in self-care (score in the lowest quartile).Results: High confidence (confident or completely confident >75 % of patients) was observed for all self-care be-havior categories except low-salt diet (63.1 %), regular exercise (63.1 %), and flu vaccination (65.9 %). Lower con-fidence in self-care behavior was associated with low quality of patient-physician communication. With regard to self-monitoring, 62.5 % of patients were not confident in distinguishing worsening symptoms of HF from other diseases; non-confidence was also associated with low quality of patient-physician communication.Conclusions: Hospitalized patients with HF had low confidence regarding regular exercise, salt restriction, and flu vaccination. The results also suggest patient-physician communication affects patient confidence.(c) 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.