Structural Relationships Between Cognitive Function, Depressive Symptoms, Self-Care Confidence, and Maintenance in...

Area of Science:

• Cardiology
• Neuropsychology
• Behavioral Science

Background:

• Heart failure (HF) management requires effective self-care maintenance behaviors.
• Understanding the cognitive and psychological factors influencing self-care is essential for improving patient outcomes.

Purpose of the Study:

• To identify the structural relationships between cognitive function domains, depression, self-care confidence, and self-care maintenance in patients with heart failure.
• To elucidate the direct and indirect pathways influencing self-care maintenance behavior in HF patients.

Main Methods:

• Secondary analysis of data from 201 heart failure patients across three Korean hospitals.
• Utilized structural equation modeling to analyze relationships between cognitive function (assessed by Seoul Neuropsychological Screening Battery) and self-care (assessed by Self-Care of HF Index v.6.2).

Main Results:

• Self-care maintenance was directly and significantly influenced by memory function (β=.43) and self-care confidence (β=.70).
• Memory and global cognitive functions indirectly impacted self-care maintenance via self-care confidence (β=-.37 and β=.14, respectively).
• Depressive symptoms also indirectly affected self-care maintenance through self-care confidence (β=-.21).

Conclusions:

• Enhancing self-care confidence and preserving memory function are critical for long-term self-care maintenance in chronic heart failure.
• Regular memory assessments and targeted interventions to improve cognitive function and self-care confidence are recommended for HF patients.