The self-efficacy perception in cardiovascular patients: A cohort study on self-care management

The international cardiovascular guidelines emphasise self-care as a key factor for better health management in patients. Self-care incorporated into patient engagement is considered vital for the patient-provider relationship to alleviate the polipharmacological treatment burden. However, several cardiovascular (CV) patients struggle to adhere to recommendations. The present study aims to address this research gap by exploring the adherence and real-world effectiveness in a CV population. From this perspective, our cohort study attempted to determine self-care ability based on the relevance of self-efficacy and quality of life perception in adults with a CV condition.

An observational study design was applied based on cohort analysis. A total of 76 patients at different stages of disease severity participated in the study. Two types of patient data were collected: medical data-drawn from clinical records and psychological data-collected through interviews and the following standardised questionnaires: the EuroQol Visual Analogue, Self-Care of Chronic Illness Inventory, Self-Care Self-Efficacy Scale. All clinical data were recorded during the outpatient scheduled follow-up.

Our results evidenced that patients with hypertension and heart failure need greater engagement actions and education support from providers to achieve the goal of medical treatments modelling health behaviour that prioritises monitoring ability over time. CV risk factors were more regulated in the self-care monitoring group than in the heart failure group; in CV diseases, patients with ischemic heart disease seemed more efficient in self-monitoring than those with heart failure. Relevant results were obtained in self-efficacy perception; the comparison between hypercholesterolaemia and heart failure groups resulted in statistical significance, indicating that patients with hypercholesterolaemia perceive a higher ability to achieve positive outcomes for their own health; other patient groups did not seem to perceive high self-efficacy.

In chronic diseases, such as cardiological conditions, monitoring ability seems to be a challenging clinical variable; the ability to check signs and symptoms, and actions associated with the complexity of physical signs and multimorbidity could be impacted over time. Our findings suggest that fostering self-efficacy capacity could induce better physical self-monitoring for enhanced well-being and greater self-confidence regarding the management of health-favouring behaviours and lifestyle-modelled changes.