Structural equation model testing the situation-specific theory of heart failure self-care
Version of Record online: 21 MAR 2013
© 2013 Blackwell Publishing Ltd
Journal of Advanced Nursing
Volume 69, Issue 11, pages 2481–2492, November 2013
How to Cite
2013) Structural equation model testing the situation-specific theory of heart failure self-care. Journal of Advanced Nursing 69(11), 2481–2492. 10.1111/jan.12126, , , , , & (
- Issue online: 6 OCT 2013
- Version of Record online: 21 MAR 2013
- Manuscript Accepted: 9 FEB 2013
- Italian Center of Excellence for Nursing Scholarship
- heart failure;
- structural equation modelling;
- symptom monitoring;
- symptom recognition and evaluation;
- theory testing;
- treatment adherence;
- treatment implementation
To test the situation-specific theory of heart failure self-care with structural equation modelling.
Several authors have proposed theories on heart failure self-care, but only the situation-specific theory of heart failure self-care by Riegel and Dickson is focused on the process that patients use to perform self-care. This theory has never been tested with structural equation modelling.
A secondary analysis of data from a cross-sectional study.
Patients with heart failure were recruited in 21 cardiovascular centres across Italy during 2011. Data were collected with a sociodemographic questionnaire, chart abstraction for clinical data and the Self-Care of Heart Failure Index v.6·2.
A sample of 417 participants was enrolled in the study (59% males, mean age 72 years). The following propositions were tested and supported: Symptom monitoring correlates with treatment adherence; symptom monitoring and treatment adherence have a direct, positive relationship with symptom recognition and evaluation that in turn have a direct, positive relationship with treatment implementation; treatment implementation has a direct, positive relationship with treatment evaluation. In addition, the following three relationships were found: Symptom monitoring has a direct, positive relationship with treatment implementation; symptom recognition and evaluation have direct, positive relationships with treatment evaluation and symptom monitoring correlates with treatment evaluation. [Correction added on 9th April 2013, after first online publication: ‘…symptom monitoring correlates with treatment implementation.’ has been corrected to read ‘…symptom monitoring correlates with treatment evaluation.’]
The data support the situation-specific theory of heart failure self-care with the addition of three new relationships that emerged from the analysis. Results of this study lend further support to the use of the situation-specific theory of heart failure self-care in research and practice.