Memory predicted self-care maintenance in patients with heart failure among cognitive functions: Results from a structural equation model

Abstract Background: To explain the direction of specific cognitive function training that could prevent potential self-care deficits, the cognitive domain that affects self-care behaviours in patients with heart failure (HF) should be identified. This study aimed to confirm the relationship between major potential variables affecting self-care maintenance behaviours of patients with HF. The study also aimed to determine which cognitive domain predicts self-care maintenance among patients with HF. Methods: This descriptive study involved a secondary analysis using data of 201 patients with HF from two observational studies in three Korean hospitals. The structural equation model using AMOS version 24.0 was constructed to assess the relationships among the variables. The Seoul Neuropsychological Screening Battery was used to assess global cognition, immediate/delayed memory, and executive function, and the Self-Care of Heart Failure Index v.6.2. was used for self-care confidence and maintenance. Results: Self-care maintenance was affected by memory function with a significant direct effect (β=.43, p=.006), as well as self-care confidence (β=.70, p<.001). Memory function and global function indirectly affected self-care maintenance through self-care confidence (β=-.37, p=.002; β=.14, p=.030). Depressive symptoms also had an indirect effect through self-care confidence on self-care maintenance (β=-.21, p=.005). Conclusion: This study confirmed the need for periodic simple screening of the memory function and training to raise it in patients with HF, enhancing their self-care behaviours. It also suggests that supportive intervention is needed to enhance self-confidence as a mediator.