Dynamic trends and influencing factors of self-care behaviours among Chinese older adults with chronic heart failure during vulnerable period: a longitudinal study

Abstract

Aims: To explore the trends of self-care behaviours among Chinese older adults with chronic heart failure (CHF) during the vulnerable period (VP) and to analyze influencing factors.

Methods and results: This was a longitudinal study. From October 2022 to July 2023, 255 patients were recruited from a tertiary hospital in Shanghai, China. Data regarding self-care behaviours (self-care maintenance, symptom perception, and self-care management), self-care confidence, illness perception, self-efficacy, social support, HF knowledge, and demographic and clinical information were collected during hospitalization (T1) utilizing validated questionnaires and electronic health records. Follow-up behavioural data were collected at 2 weeks (T2), 4 weeks (T3), 2 months (T4), and 3 months (T5) post-discharge. Repeated measures ANOVA was used to identify the trends of self-care behaviours, and the generalized estimation equation was used to explore influencing factors. Self-care maintenance scores reached 70 at T2, T4, and T5, while self-care management scores exceeded 70 at time points from T2 to T5. Symptom perception scores never reached 70 any single time point. There were significant temporal variations across all 3 domains, characterized by a rapid improvement at 2 weeks post-discharge, followed by subsequent stabilization or decline (P < 0.05). Residential area, educational level, cardiac function, self-care confidence, and HF knowledge were key influencing factors (P < 0.05).

Conclusion: Self-care behaviours among patients improved within the first two weeks post-discharge but tended to stabilize or decline thereafter, indicating a critical window for targeted interventions. Health care professionals should tailor self-care promotion strategies to both the temporal patterns of behaviours and patient-specific characteristics.

Keywords: Aged; Dynamic trends; Heart failure; Longitudinal studies; Self care.