Executive dysfunction is associated with self-care confidence in patients with heart failure

Aim: To explore differences in self-care maintenance, management and confidence levels between American heart failure (HF) patients with and without executive dysfunction. Background: Evidence indicates some aspect of cognitive impairment is prevalent in up to 75% of the HF patient population. Moreover, cognitive impairment has been identified as a barrier to adequate self-care contributing to poor outcomes. There is limited understanding of the role executive function, a domain of cognitive performance, has on self-care behaviors for patients with HF. Method: This secondary analysis examined the role of executive function, measured by the Clock Drawing Test (CDT), in relation to self-care measures. The Self Care of Heart Failure Index v6.2 (SCHFI v6.2) was used to measure self-care maintenance, management, and confidence. Results: Participants had a mean age of 75.1 +/- 12.5 years, identified as male (59.4%), with New York Heart Association (NYHA) class III (57.3%). Executive function impairment was present in 28% of the sample. Comparison of self-care maintenance and management scores between the two groups were not significant. However, participants with executive dysfunction demonstrated an average self-care confidence score of 48.6 +/- 23.3, while participants with no executive function impairment demonstrated a higher average self-care confidence score of 61.5 +/- 18.4. Differences in self-care confidence scores between the groups were statistically significant (p = .014). Conclusions: HF self-care confidence is considered a moderator of self-care behaviors. Understanding the influence executive function has on self-care confidence may lead to a better understanding of those needing greater support with self-care behaviors.