• Nancy M Albert, Phillip Levy, Elizabeth Langlois, Benjamin Nutter, Dongsheng Yang, Vijaya Arun Kumar, Patrick Medado, and Elizabeth Nykun.
• Nursing Institute and Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, Ohio.
• J Emerg Med. 2014 Jan 1; 46 (1): 122-9.

BackgroundHeart failure (HF) emergency department (ED) visits are commonly due to HF self-care nonadherence.ObjectiveOur objective was to assess the accuracy of HF beliefs and adherence to self care in patients using an ED for acute HF.MethodsA cross-sectional, correlational study using validated surveys of HF beliefs and self-care adherence was conducted. A multivariable regression model was used to control for significant baseline factors.ResultsIn 195 adults, mean HF beliefs score was 2.8 ± 0.3, significantly below the accurate cutoff score of 3.0 (p < 0.001). Mean HF self-care adherence score was 5.1 (10 reflects best adherence). Of HF-related self-care behaviors, adherence was highest for taking medications without skipping or missing doses (7.8 ± 3.3) and lowest for daily weight monitoring (3.5 ± 3.5). Higher accuracy in HF beliefs was associated with higher education level (p = 0.01), younger age (p < 0.001), and choosing low-sodium restaurant foods (p = 0.04), but not with adherence to other self-care behaviors. Self-care adherence was associated with the belief that the HF care plan must be followed forever (p = 0.04), but not with other HF beliefs; and there was a trend toward lower HF self-care adherence when HF belief scores were more accurate. After controlling for significant baseline factors, HF beliefs were not associated with self-care adherence (p = 0.15).ConclusionsPatients seeking ED care for decompensated HF had inaccurate HF beliefs and poor self-care adherence. Lack of association between HF beliefs and self care (and trend of an inverse relationship) reflects a need for predischarge HF education, including an explanation of what HF means and how it can be better controlled through self-care behaviors.Copyright © 2014 Elsevier Inc. All rights reserved.

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