Date of Award

May 2019

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Nursing

First Advisor

Kim Litwack

Committee Members

Julie Ellis, Michael Brondino, Sandeep Gopalakrishnan

Keywords

Cross-sectional Study, Heart Failure, Nursing, Self-Management

Abstract

Heart failure is a chronic health problem. Heart failure is costly for society, resulting in high morbidity and mortality which accounts for large public spending on this disease. Heart failure (HF) management is complex and requires coordination between patients, families, and their health team members. Self-management (SM) of HF is an important component of chronic disease management and, when done well, aids in preventing HF exacerbations and unnecessary hospitalizations. There are gaps in nursing knowledge of as to which strategies best account for successful outcomes of SM in HF and which patient attributes help contribute to better SM. To clarify these gaps, this dissertation tested concepts of the Individual and Family Self-Management Theory (Rayan & Sawin, 2009). This dissertation also examined association of the complexity of conditions, self-regulation and self-efficacy with self-management behavior in a population of patients with heart failure from a large Midwestern hospital. This was a cross-sectional correlational study. Complexity of conditions was not associated with heart failure behavior, and self-regulation and self-efficacy predicted some but not all self-management behaviors and there was no mediation among the variables. This study contributed to the accumulated knowledge of heart failure self-management and when seeking explanations for the study findings, underlined challenges of HF self-management.

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