Confidence in self-care after heart failure hospitalization

Shun Hashimoto, Hiroki Kitakata, Shun Kohsaka, Daisuke Fujisawa, Yasuyuki Shiraishi, Naomi Nakano, Otoya Sekine, Yoshikazu Kishino, Yoshinori Katsumata, Shinsuke Yuasa, Keiichi Fukuda, Takashi Kohno

Research output: Contribution to journalArticlepeer-review


Background: Understanding patient perspectives of self-care is critical for improving multidisciplinary education programs and adherence to such programs. However, perspectives of self-care for patients with heart failure (HF) as well as the association between patient perspectives and patient-physician communication remain unclear. Methods: Confidence levels regarding self-care behaviors (eight lifestyle behaviors and four consulting behaviors) and self-monitoring were assessed using a self-administered questionnaire survey, which was directly distributed by dedicated physicians and nurses to consecutive patients hospitalized with HF in a tertiary-level hospital. Patient-physician communication was evaluated according to the quality of physician-provided information regarding “treatment and treatment choices” and “prognosis” using the Prognosis and Treatment Perception Questionnaire. Out of 202 patients, 187 (92.6 %) agreed to participate, and 176 completed the survey [valid response rate, 87.1 %; male, 67.0 %; median age, 73 (63–81) years]. Multivariate logistic regression analyses were conducted to predict low confidence in self-care (score in the lowest quartile). Results: High confidence (confident or completely confident >75 % of patients) was observed for all self-care behavior categories except low-salt diet (63.1 %), regular exercise (63.1 %), and flu vaccination (65.9 %). Lower confidence in self-care behavior was associated with low quality of patient-physician communication. With regard to self-monitoring, 62.5 % of patients were not confident in distinguishing worsening symptoms of HF from other diseases; non-confidence was also associated with low quality of patient-physician communication. Conclusions: Hospitalized patients with HF had low confidence regarding regular exercise, salt restriction, and flu vaccination. The results also suggest patient-physician communication affects patient confidence.

Original languageEnglish
Pages (from-to)42-48
Number of pages7
JournalJournal of Cardiology
Issue number1
Publication statusPublished - 2023 Jan
Externally publishedYes


  • Heart failure
  • Patient education
  • Patient perspective
  • Patient-centered care
  • Self-care

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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