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Social Support and Self-Care of Patients with Heart Failure

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Social support can influence treatment adherence of patients with chronic illnesses, which may explain the positive effects of social support on heart failure (HF) outcomes.

Purpose

To investigate the effects of social support among patients with HF, we examined whether aspects of social support were associated with self-care, including medication adherence, dietary adherence, and HF symptom monitoring functions.

Methods

We recruited 74 patients with HF from cardiology clinics of a Veterans Affairs Medical Center and a university-affiliated hospital, and tested the relationships between social support and the patients’ self-care.

Results

Consistent with previous research in older adults, family members, especially spouses, were often involved in the medical care of patients with chronic HF and provided a range of levels of support to patients. Self-care was generally poor, as measured across several self-care domains. Perceived social support was moderately associated with relatively better self-reported medication and dietary adherence, and other aspects of self-care such as daily weighing.

Conclusions

These findings suggest that a relatively higher level of self-care is an important correlate of social support and may explain how social support influences HF outcomes. This study also suggests that family members should play a greater part in clinical care focused on improving self-care.

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References

  1. Rosamond W, Flegal K, Friday G, et al. Heart disease and stroke statistics—2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation 2006; 115: e69–e171.

    Article  PubMed  Google Scholar 

  2. O’Connell JB. The economic burden of heart failure. Clin Cardiol. 2000; 23: III6–10.

    Article  PubMed  CAS  Google Scholar 

  3. Ni H, Nauman DJ, Hershberger RE. Analysis of trends in hospitalizations for heart failure. J Card Fail. 1999; 5: 79–84.

    Article  PubMed  CAS  Google Scholar 

  4. Smith DM, Giobbie-Hurder A, Weinberger M, et al. Predicting non-elective hospital readmissions: a multi-site study. Department of Veterans Affairs Cooperative Study Group on Primary Care and Readmissions. J Clin Epidemiol. 2000; 53: 1113–1118.

    Article  PubMed  CAS  Google Scholar 

  5. Krumholz HM, Parent EM, Tu N, et al. Readmission after hospitalization for congestive heart failure among Medicare beneficiaries. Arch Intern Med. 1997; 157: 99–104.

    Article  PubMed  CAS  Google Scholar 

  6. Silver MA. Advancing the advances in heart failure: updates on newer therapies. Congest Heart Fail. 2005; 11: 176.

    Article  Google Scholar 

  7. McAlister FA, Stewart S, Ferrua S, McMurray JJJV. Multidisciplinary strategies for the management of heart failure patients at high risk for admission: a systematic review of randomized trials. J Am Coll Cardiol. 2004; 44: 810–819.

    PubMed  Google Scholar 

  8. Rozanski A, Blumenthal JA, Davidson KW, Saab PG, Kubzansky L. The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: the emerging field of behavioral cardiology. J Am Coll Cardiol. 2005; 45: 637–651.

    Article  PubMed  Google Scholar 

  9. MacMahon KMA, Lip GYH. Psychological factors in heart failure: a review of the literature. Arch Intern Med. 2002; 162: 509–516.

    Article  PubMed  Google Scholar 

  10. Luttik ML, Jaarsma T, Moser D, Sanderman R, van Veldhuisen DJ. The importance and impact of social support on outcomes in patients with heart failure: an overview of the literature. J Cardiovasc Nurs. 2005; 20: 162–169.

    PubMed  Google Scholar 

  11. Moser DK, Worster PL. Effect of psychosocial factors on physiologic outcomes in patients with heart failure. J Cardiovasc Nurs. 2000; 14: 106–115.

    PubMed  CAS  Google Scholar 

  12. Murberg TA. Long-term effect of social relationships on mortality in patients with congestive heart failure. Int J Psychiatry Med. 2004; 34: 207–217.

    Article  PubMed  Google Scholar 

  13. DiMatteo MR. Social Support and Patient Adherence to Medical Treatment: A Meta-Analysis. Health Psychol. 2004; 23: 207–218.

    Article  PubMed  Google Scholar 

  14. Cohen S. Social relationships and health. Am Psychol. 2004; 59: 676–684.

    Article  PubMed  Google Scholar 

  15. Cohen S. Psychosocial models of the role of social support in the etiology of physical disease. Health Psychol. 1988; 7: 269–297.

    Article  PubMed  CAS  Google Scholar 

  16. Riegel B, Carlson B, Glaser D. Development and testing of a clinical tool measuring self-management of heart failure. Heart Lung. 2000; 29: 4–15.

    Article  PubMed  CAS  Google Scholar 

  17. Jessup M, Brozena S. Heart failure. N Engl J Med. 2003; 348: 2007–2018.

    Article  PubMed  Google Scholar 

  18. Monane M, Bohn RL, Gurwitz JH, Glynn RJ, Avorn J. Noncompliance with congestive heart failure therapy in the elderly. Arch Intern Med. 1994; 154: 433–437.

    Article  PubMed  CAS  Google Scholar 

  19. Ghali J, Kadakia S, Cooper R, Ferlinz J. Precipitating factors leading to decompensation off heart failure. Arch Intern Med. 1988; 148: 2013–2016.

    Article  PubMed  CAS  Google Scholar 

  20. Tsuyuki RT, McKelvie RS, Arnold JM, et al. Acute precipitants of congestive heart failure exacerbations. Arch Intern Med. 2001; 161: 2337–2342.

    Article  PubMed  CAS  Google Scholar 

  21. Ni H, Nauman D, Burgess D, et al. Factors influencing knowledge of and adherence to self-care among patients with heart failure. Arch Intern Med. 1999; 159: 1613–1619.

    Article  PubMed  CAS  Google Scholar 

  22. Shumaker SA, Hill DR. Gender differences in social support and physical health. Health Psychol. 1991; 10: 102–111.

    Article  PubMed  CAS  Google Scholar 

  23. Umberson D. Family status and health behaviors: social control as a dimension of social integration. J Health Soc Behav. 1987; 28: 306–319.

    Article  PubMed  CAS  Google Scholar 

  24. Umberson D. Gender, marital status and the social control of health behavior. Soc Sci Med. 1992; 34: 907–917.

    Article  PubMed  CAS  Google Scholar 

  25. Sayers SL, White T, Zubritsky C, Oslin DW. Family involvement in the care of healthy medical outpatients. Fam Pract. 2006; 23: 317–324.

    Article  PubMed  Google Scholar 

  26. Simpson SH, Johnson JA, Farris KB, Tsuyuki RT. Development and validation of a survey to assess barriers to drug use in patients with chronic heart failure. Pharmacotherapy. 2002; 22: 1163–1172.

    Article  PubMed  Google Scholar 

  27. Bennett SJ, Perkins SM, Lane KA, et al. Social support and health-related quality of life in chronic heart failure patients. Qual Life Res. 2001; 10: 671.

    Article  PubMed  CAS  Google Scholar 

  28. Griffin ML, Amodeo M, Clay C, Fassler I, Ellis MA. Racial differences in social support: kin versus friends. Am J Orthopsychiatr. 2006; 76: 374–380.

    Article  Google Scholar 

  29. Stack CB. All Our Kin: Strategies for Survival in a Black Community. New York: Harper & Row; 1974.

    Google Scholar 

  30. Hogan DP, Eggebeen DJ, Clogg CC. The structure of intergenerational exchanges in American families. Am J Sociol. 1993; 98: 1428–1458.

    Article  Google Scholar 

  31. Hogan DP, Hao L-X, Parish WL. Race, kin networks, and assistant to mother-headed families. Soc Forces. 1990; 68: 797–812.

    Article  Google Scholar 

  32. Roschelle AR. No More Kin: Exploring Race, Class, and Gender in Family Networks. Thousand Oaks: Sage; 1997.

    Google Scholar 

  33. Waite LJ, Harrison SC. Keeping in touch: How women in mid-life allocate social contacts among kith and kin. Soc Forces. 1992; 70: 637–655.

    Article  Google Scholar 

  34. Stewart D, Vaux A. Social support resources, behaviors, and perceptions among black and white college students. J Multicult Couns Devel. 1986; 14: 65–72.

    Google Scholar 

  35. Wood JB, Parham IA. Coping with perceived burden: Ethnic and cultural issues in Alzheimer’s family caregiving. J Appl Gerontol. 1990; 9: 325–339.

    Article  Google Scholar 

  36. Haley WE, West CA, Wadley VG, et al. Psychological, social, and health impact of caregiving: a comparison of black and white dementia family caregivers and noncaregivers. Psychol Aging. 1995; 10: 540–552.

    Article  PubMed  CAS  Google Scholar 

  37. Katzman R, Brown T, Fuld P, et al. Validation of a short Orientation-Memory-Concentration Test of cognitive impairment. Am J Psychiatr. 1983; 140: 734–739.

    PubMed  CAS  Google Scholar 

  38. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986; 24: 67–74.

    Article  PubMed  CAS  Google Scholar 

  39. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40: 373–383.

    Article  PubMed  CAS  Google Scholar 

  40. Goring H, Baldwin R, Marriott A, Pratt H, Roberts C. Validation of short screening tests for depression and cognitive impairment in older medically ill inpatients. Int J Geriatr Psychiatry. 2004; 19: 465–471.

    Article  PubMed  Google Scholar 

  41. Petrucci RJ, Truesdell KC, Carter A, et al. Cognitive dysfunction in advanced heart failure and prospective cardiac assist device patients. Ann Thorac Surg. 2006; 81: 1738–1744.

    Article  PubMed  Google Scholar 

  42. Dahlem NW, Zimet GD, Walker RR. The multidimensional scale of perceived social support: a confirmation study. J Clin Psychol. 1991; 47: 756–761.

    Article  PubMed  CAS  Google Scholar 

  43. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess. 1988; 52: 30–41.

    Article  Google Scholar 

  44. Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the multidimensional scale of perceived social support. J Pers Assess. 1990; 55: 610–617.

    Article  PubMed  CAS  Google Scholar 

  45. Riegel B, Carlson B, Moser DK, et al. Psychometric testing of the self-care of heart failure index. J Card Fail. 2004; 10: 350–360.

    Article  PubMed  Google Scholar 

  46. Lipshitz R, Klein G, Orasanu J, Salas E. Taking stock of naturalistic decision making. J Behav Decis Mak. 2001; 14: 331–352.

    Article  Google Scholar 

  47. Chamak C, Sayers SL, Pawlowski S, et al. A new measure of adherence to a sodium-restricted diet. Presented at the Annual Meeting of the American Psychological Association. Washington, DC; 2005.

  48. Trobst KK. An interpersonal conceptualization and quantification of social support transactions: Social support as an interpersonal construct. Pers Soc Psychol Bull. 2000; 26: 971–986.

    Article  Google Scholar 

  49. Lewis MA, Rook KS. Social control in personal relationships: impact on health behaviors and psychological distress. Health Psychol. 1999; 18: 63–71.

    Article  PubMed  CAS  Google Scholar 

  50. Berkman LF, Blumenthal JA, Burg MM, et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) randomized trial. J Am Med Assoc. 2003; 289: 3106–3116.

    Article  Google Scholar 

  51. Burg MM, Barefoot J, Berkman L, et al. Low perceived social support and post-myocardial infarction prognosis in the enhancing recovery in coronary heart disease clinical trial: the effects of treatment. Psychosom Med. 2005; 67: 879–888.

    Article  PubMed  Google Scholar 

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Acknowledgment

This work was supported by grant 0265447U from the American Heart Association, a VISN 4 Competitive Pilot Project Fund grant from the Department of Veterans Affairs, and the Mental Illness Research, Education, and Clinical Center of VISN 4. We extend our appreciation to Bruce Dunkman, MD; Lawrence Frame, MD; Joyce McGrory, ACNP; and Susan Potts-Nulty, ACNP, for their help in recruiting patients for face-to-face assessment. Many thanks to Robert Carels, PhD; Kate Taylor, PhD; and Shahrzad Mavandadi, Ph.D., for their expert comments on an earlier version of this paper, as well as the helpful comments of three anonymous reviewers.

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Correspondence to Steven L. Sayers Ph.D..

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Sayers, S.L., Riegel, B., Pawlowski, S. et al. Social Support and Self-Care of Patients with Heart Failure. ann. behav. med. 35, 70–79 (2008). https://doi.org/10.1007/s12160-007-9003-x

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  • DOI: https://doi.org/10.1007/s12160-007-9003-x

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