The impact of self-management knowledge and support on the relationships among self-efficacy, patient activation, and self-management in rural patients with heart failure

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Abstract

Background: Self-management (SM) is an essential component of heart failure (HF) management. The mechanisms to improve SM behaviors are unclear. Objective: The objective of this study is to examine whether patient activation mediates the effect of self-efficacy on SM behaviors in rural HF patients. Methods: A secondary analysis was conducted using data collected from a randomized controlled trial aimed to improve SM behaviors. The main variables included were SM knowledge, self-efficacy, patient activation, and SM behaviors. Results: Mediation analysis showed patient activation mediated the effect of self-efficacy on SM. Both self-efficacy and patient activation were significantly related to SM behaviors, respectively (r = 0.46, P G .001; " = .48, P = .001). However, self-efficacy was no longer directly related to SM behaviors when patient activation was entered into the final model (" = .17, P = .248). Self-management knowledge and support were significant moderators. In patients with high levels of SM knowledge, patient activation did not mediate the effect of self-efficacy on SM behaviors (" = .15, P = .47). When SM support was entered in the path model, patient activation was not a significant mediator between self-efficacy and SM behavior at high (" = .27, P = .27) or low (" = .27, P = .25) levels of SM support. Conclusions: Study findings suggest that targeted SM support for high-risk HF patients with low SM knowledge and support may be useful. In addition, strategies to increase patient activation may improve HF patients' SM confidence.

Original languageEnglish (US)
Pages (from-to)E1-E8
JournalJournal of Cardiovascular Nursing
Volume32
Issue number4
DOIs
StatePublished - Jan 1 2017

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Patient Participation
Self Efficacy
Self Care
Heart Failure

Keywords

  • Heart failure
  • Knowledge
  • Patient activation
  • Rural health
  • Self-management behavior

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

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title = "The impact of self-management knowledge and support on the relationships among self-efficacy, patient activation, and self-management in rural patients with heart failure",
abstract = "Background: Self-management (SM) is an essential component of heart failure (HF) management. The mechanisms to improve SM behaviors are unclear. Objective: The objective of this study is to examine whether patient activation mediates the effect of self-efficacy on SM behaviors in rural HF patients. Methods: A secondary analysis was conducted using data collected from a randomized controlled trial aimed to improve SM behaviors. The main variables included were SM knowledge, self-efficacy, patient activation, and SM behaviors. Results: Mediation analysis showed patient activation mediated the effect of self-efficacy on SM. Both self-efficacy and patient activation were significantly related to SM behaviors, respectively (r = 0.46, P G .001; {"} = .48, P = .001). However, self-efficacy was no longer directly related to SM behaviors when patient activation was entered into the final model ({"} = .17, P = .248). Self-management knowledge and support were significant moderators. In patients with high levels of SM knowledge, patient activation did not mediate the effect of self-efficacy on SM behaviors ({"} = .15, P = .47). When SM support was entered in the path model, patient activation was not a significant mediator between self-efficacy and SM behavior at high ({"} = .27, P = .27) or low ({"} = .27, P = .25) levels of SM support. Conclusions: Study findings suggest that targeted SM support for high-risk HF patients with low SM knowledge and support may be useful. In addition, strategies to increase patient activation may improve HF patients' SM confidence.",
keywords = "Heart failure, Knowledge, Patient activation, Rural health, Self-management behavior",
author = "Lufei Young and Kupzyk, {Kevin A} and Barnason, {Susan Ann}",
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T1 - The impact of self-management knowledge and support on the relationships among self-efficacy, patient activation, and self-management in rural patients with heart failure

AU - Young, Lufei

AU - Kupzyk, Kevin A

AU - Barnason, Susan Ann

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N2 - Background: Self-management (SM) is an essential component of heart failure (HF) management. The mechanisms to improve SM behaviors are unclear. Objective: The objective of this study is to examine whether patient activation mediates the effect of self-efficacy on SM behaviors in rural HF patients. Methods: A secondary analysis was conducted using data collected from a randomized controlled trial aimed to improve SM behaviors. The main variables included were SM knowledge, self-efficacy, patient activation, and SM behaviors. Results: Mediation analysis showed patient activation mediated the effect of self-efficacy on SM. Both self-efficacy and patient activation were significantly related to SM behaviors, respectively (r = 0.46, P G .001; " = .48, P = .001). However, self-efficacy was no longer directly related to SM behaviors when patient activation was entered into the final model (" = .17, P = .248). Self-management knowledge and support were significant moderators. In patients with high levels of SM knowledge, patient activation did not mediate the effect of self-efficacy on SM behaviors (" = .15, P = .47). When SM support was entered in the path model, patient activation was not a significant mediator between self-efficacy and SM behavior at high (" = .27, P = .27) or low (" = .27, P = .25) levels of SM support. Conclusions: Study findings suggest that targeted SM support for high-risk HF patients with low SM knowledge and support may be useful. In addition, strategies to increase patient activation may improve HF patients' SM confidence.

AB - Background: Self-management (SM) is an essential component of heart failure (HF) management. The mechanisms to improve SM behaviors are unclear. Objective: The objective of this study is to examine whether patient activation mediates the effect of self-efficacy on SM behaviors in rural HF patients. Methods: A secondary analysis was conducted using data collected from a randomized controlled trial aimed to improve SM behaviors. The main variables included were SM knowledge, self-efficacy, patient activation, and SM behaviors. Results: Mediation analysis showed patient activation mediated the effect of self-efficacy on SM. Both self-efficacy and patient activation were significantly related to SM behaviors, respectively (r = 0.46, P G .001; " = .48, P = .001). However, self-efficacy was no longer directly related to SM behaviors when patient activation was entered into the final model (" = .17, P = .248). Self-management knowledge and support were significant moderators. In patients with high levels of SM knowledge, patient activation did not mediate the effect of self-efficacy on SM behaviors (" = .15, P = .47). When SM support was entered in the path model, patient activation was not a significant mediator between self-efficacy and SM behavior at high (" = .27, P = .27) or low (" = .27, P = .25) levels of SM support. Conclusions: Study findings suggest that targeted SM support for high-risk HF patients with low SM knowledge and support may be useful. In addition, strategies to increase patient activation may improve HF patients' SM confidence.

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