Anxiety and self-care behaviour in patients with chronic systolic heart failure: a multivariate model

Background: While comprehensive evidence exists regarding negative effects of depression on self-care behaviours in patients with chronic heart failure (CHF), the relation between anxiety and self-care behaviours in patients with CHF is not clear. The aim of this study was to analyse the interaction...

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Main Authors: Müller-Tasch, Thomas (Author) , Loßnitzer, Nicole (Author) , Frankenstein, Lutz (Author) , Täger, Tobias (Author) , Haass, Markus (Author) , Katus, Hugo (Author) , Schultz, Jobst-Hendrik (Author) , Herzog, Wolfgang (Author)
Format: Article (Journal)
Language:English
Published: 2018
In: European journal of cardiovascular nursing
Year: 2017, Volume: 17, Issue: 2, Pages: 170-177
ISSN:1873-1953
DOI:10.1177/1474515117722255
Online Access:Verlag, Pay-per-use, Volltext: https://doi.org/10.1177/1474515117722255
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Author Notes:Thomas Müller-Tasch, Bernd Löwe, Nicole Lossnitzer, Lutz Frankenstein, Tobias Täger, Markus Haass, Hugo Katus, Jobst-Hendrik Schultz and Wolfgang Herzog

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520 |a Background: While comprehensive evidence exists regarding negative effects of depression on self-care behaviours in patients with chronic heart failure (CHF), the relation between anxiety and self-care behaviours in patients with CHF is not clear. The aim of this study was to analyse the interactions between anxiety, depression and self-care behaviours in patients with CHF. Methods: The self-care behaviour of CHF outpatients was measured using the European Heart Failure Self-care Behaviour Scale (EHFScBS). The Patient Health Questionnaire (PHQ) was used to assess anxiety, the PHQ-9 was used to measure depression severity. Differences between patients with and without anxiety were assessed with the respective tests. Associations between anxiety, self-care and other predictors were analysed using linear regressions. Results: Of the 308 participating patients, 35 (11.4%) fulfilled the PHQ criteria for an anxiety disorder. These patients took antidepressants more frequently (11.8% versus 2.3%, p = .02), had had more contacts with their general practitioner within the last year (11.8 ± 16.1 versus 6.7 ± 8.6, p = .02), and had a higher PHQ-9 depression score (12.9 ± 5.7 versus 6.5 ± 4.7, p < .01) than patients without anxiety disorder. Anxiety and self-care were negatively associated (ß = ?0.144, r2 = 0.021, p = 0.015). The explanation of variance was augmented in a multivariate regression with the predictors age, sex, education, living with a partner, and New York Heart Association (NYHA) class (r2 = 0.098) when anxiety was added (r2 = 0.112). Depression further increased the explanation of variance (ß = ?0.161, r2 = 0.131, p = 0.019). Conclusions: Anxiety is negatively associated with self-care behaviour in patients with CHF. However, this effect disappears behind the stronger influence of depression on self-care. The consideration of mental comorbidities in patients with CHF is important. 
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