Exploring the relationships between socioecological determinants of health and heart failure self-care

There is limited research regarding the combined influence of several socioecological determinants of health on heart failure self-care.

This study analyzes the influence of food insecurity, health literacy, emotional and instrumental support on heart failure self-care.

A cross-sectional, descriptive, correlational survey of 88 participants with heart failure was conducted. Multiple correlations and simultaneous multiple linear regressions were used to answer research questions.

Emotional support and instrumental support correlated with self-care maintenance (r = 0.35, p < .001; r = 0.29, p = .006), symptom perception (r = 0.37, p < .001; r = 0.3, p = .005), and self-care management (r = 0.27, p = .012; r = 0.23, p = .033), with stronger associations for emotional support across all three measures. The combined impact of emotional support, food security, and health literacy contributed 15% of the total variance in self-care maintenance (p = .003), 22% of the total variance in self-care perception (p < .001), and 11% of the total variance in self-care management (p = .02). When combined, the impact of instrumental support, food security, and health literacy significantly contributed 12% of the total variance in self-care maintenance (p = .013), 19% of the total variance in symptom perception (p < .001), 10% of the total variance in self-care management (p = .04). These findings remained significant after controlling for depression and socioeconomic status.

This study contributes to the limited knowledge of the impact of socioecological determinants of health in heart failure self-care. Food insecurity and health literacy did not independently correlate to self-care but predicted self-care when combined with emotional or instrumental support.