What is the clinical evidence from this study?

Study design: Observational. Population: Heart Failure (n=333). Intervention: High level of social support vs. Low or moderate levels of social support. Primary outcome: Self-care behavior (p=0.002).

What does this research mean for the field?

High levels of social support from a partner are associated with significantly better heart failure self-care compared to low or moderate levels of support, demonstrating that the quality of support matters more than just the presence of a partner. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

November 1, 2011Open Access

Social Support and Self-care in Heart Failure

Key Result

High levels of social support from a partner were associated with significantly better heart failure self-care compared to low or moderate levels of support (P = .002).

Study Design

Type

Observational (n=333)

Multicenter

Yes

Structured PICO

Does a high level of social support improve self-care behavior in heart failure patients?

Population

333 patients experiencing their second hospital admission for heart failure at baseline, average age 72 years, 92% NYHA class III or greater.

Intervention

High level of social support (based on the presence of a partner and perception of support received)

Comparator

Low or moderate levels of social support

Outcome

Self-care behavior measured by the European Heart Failure Self-care Behaviour Scalepatient reported

High-quality social support from a partner significantly improves self-care behaviors in heart failure patients compared to low or moderate support.

Main Result

p-value: p=0.002

Abstract

BACKGROUND AND OBJECTIVE: Self-care by heart failure (HF) patients is essential for optimal disease management of their condition. However, as the nature of HF is unrelenting and burdensome, self-care is usually achieved with the support of partners. It is not clear what role the level of social support by partners plays in HF self-care; therefore, this study sets out to determine the types of social support provided to HF patients and the impact of differing levels of social support on HF patients' self-care. SUBJECTS AND METHOD: This is secondary analysis of a subgroup of patients experiencing their second hospital admission for HF at baseline in the COACH study, a multisite trial conducted in the Netherlands. Measures included the European Heart Failure Self-care Behaviour Scale and a multiple component assessment of social support, which categorized patients into low, moderate, and high levels of social support according to the presence of a partner and their perception of support they received from their partner. RESULTS AND CONCLUSIONS: Patients (n = 333) had an average age of 72 (SD, 11) years, and 92% belonged to New York Heart Association class III or greater. Of the patients with partners (56%), only 49% had a high level of support from their partner. No demographic or clinical characteristic was associated with self-care behavior. Patients with a high level of support reported significantly better self-care (P = .002) than patients with low or moderate levels of social support. Patients with a high level of social support reported being significantly more likely to consult with a health professional for weight gain (P = .011), to limit the amount of fluids they have (P = .02), take their medication (P = .017), to get a flu shot (P = .001), and to exercise on a regular basis (P < .001) than those with medium or low levels of social support. The presence of social support by a partner is not sufficient to influence HF patients' self-care. Social support provided by partners needs to be of a quality and content that matches HF patients' perception of need to influence self-care. Caregivers, especially partners, should be considered as integral in the treatment and care of HF patients.