Factors Associated with Self-care Behavior among Heart Failure Patients in Haiduong, Vietnam

[[abstract]]Background: Heart failure is a major cause of hospitalization and readmissions worldwide, loss of working ability and productivity, and death. Self-care behavior is essential to improve health outcomes for heart failure patients. This study explored the relationship of self-care behavior with self-care knowledge and self-efficacy among heart failure patients in Vietnam.Methods: Descriptive correlational study design with convenience sample of 130 heart failure outpatients in Haiduong General Provincial Hospital, Vietnam, participated in this study. Data collection was done with European Heart Failure Self-care Behavior Scale – 9, Dutch Heart Failure Knowledge Scale v.6, and Self-care Confidence Scale of the Heart Failure Self-care Index, and the clock-drawing test. The sample size was determined by G-power Version 3.1 with a linear multiple regression model assuming R deviation from zero. Analysis of variance (ANOVA), independent t-test, the Pearson correlation and Hierarchical linear regression were used to identify the relationship among heart failure self-care behavior variable and demographic variable, self-care knowledge, and self-efficacy. Application for the approval to carry out this study was sent to the Institutional Review Board of Hanoi University of Public Health. Results: Generally, participants had a limited knowledge of heart failure self-care, moderate self-efficacy and moderately adequate self-care behavior. In this study the patients who had higher education level had better self-care knowledge (t = -2.42, p = 0.017), greater self-efficacy (t = -2.4, p = 0.018), and better heart failure self-care behavior (t = 2.44, p = 0.016). Income level was significant with self-care knowledge (f = 7.28, p = 0.001). The participants were married (t = -2.68, p = 0.008) showed higher self-efficacy than other none. Self-care knowledge (r = -0.4, p < 0.001) and self-efficacy (r = -0.46, p < 0.001) had significantly correlation with self-care behavior. A combination of self-care knowledge and self-efficacy predicted 30.7% of the variance in heart failure self-care behavior. Self-efficacy was the strongest factor affecting heart failure self-care behavior (β = 0.394, p < 0.001).Conclusion: Self-efficacy is necessary intervention to advance the self-care behavior. Nursing intervention should focus on promoting self-efficacy and enhancing self-care knowledge in order to promote and maintain self-care behaviors among heart failure patients. Keywords: Heart failure, self-efficacy, knowledge, self-care behavio