Factors associated with beliefs about adherence to
					non-pharmacological treatment of patients with heart failure

Saccomann, Izabel Cristina Ribeiro da Silva; Cintra, Fernanda Aparecida; Gallani, Maria Cecília Bueno Jayme

doi:10.1590/S0080-623420140000100002

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Original Article • Rev. esc. enferm. USP 48 (1) • Feb 2014 • https://doi.org/10.1590/S0080-623420140000100002 copy

Factors associated with beliefs about adherence to non-pharmacological treatment of patients with heart failure^* * Extracted of the thesis "Educação em saúde na adesão ao tratamento e na qualidade de vida em portadores de insuficiência cardíaca", Post-Graduation Nursing Program, Faculdade de Enfermagem, Universidade Estadual de Campinas, 2012

Factores asociados a las creencias sobre la adherencia al tratamiento no farmacológico de pacientes con insuficiencia cardíaca

Authorship SCIMAGO INSTITUTIONS RANKINGS

This study aimed at assessing beliefs about the benefits and barriers to adherence to daily self-monitoring of weight/edema in patients with heart failure, and the influence of demographic and clinical variables on those beliefs. 105 patients were interviewed. The mean of the subscales Benefits and Barriers were 20.2 (± 5.7) and 30.1 (±7.1), respectively. Patients perceived that adherence to daily self-monitoring of weight/edema could keep them healthy, improve their quality of life and decrease the chances of readmission. Approximately half of patients (46.7%) reported forgetting this measure. Those who controlled weight once a month were more likely to have barriers to adherence (OR= 6.6; IC 95% 1.9-13.8; p=0.01), showing this measure to be the main factor related to perceived barriers. Education in health can contribute with the development of strategies aimed at lowering barriers and increasing benefits of this control.

Heart failure; Medication adherence; Patient compliance; Disease management; Nursing care

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Correspondence: Izabel Cristina Ribeiro da Silva Saccomann, Rua Ilda do Amaral Cussiol, 320 – Jardim Isaura, CEP 18047-594 – Sorocaba, SP, Brazil

Sociodemographic Characteristics	Mean (sd)	N (%)
Age (years)	66.1 (9.4)
≤ 60		26 (24.8)
> 60 ≤ 75		66 (62.9)
>75		13 (12.4)
Gender
Female		56 (53.3)
Male		49 (46.7)
Color/ethnicity
White		80 (76.2)
Not white		25 (23.8)
Marital Status
Married		70 (66.6)
Not married		35 (33.3)
Work status
Retired		79 (75.2)
Employed		12 (11.4)
Without income		14 (13.3)
Education (years of study)	4.1 (3.3)
Income (minimum wage)	1.9 (1.0)
Clinical characteristics
Time with HF (years)	9.9 (7.9)
Etiology
Hipertension		55 (52.3)
Coronary disease		29 (27.7)
Chagas disease		13 (12.4)
Cardiomyopathy		08 (7.6)
Functional Class (New York Heart Association)
CF I		19 (18.1)
CF II		61 (58.1)
CF III/IV		25 (23.8)
Left Ventricle Ejection Fraction	51.0 (13.5)
Normal (≥ 50 %)		60 (57.1)
Lowered (< 50 %)		45 (42.9)
Comorbidities	2.3 (1.8)
1		54 (51.4)
2		37 (35.2)
≥ 3		14 (13.3)
Diuretics used
Furosemide		72 (68.6)
Hydrochlorothiazide		46 (43.8)
Spironolactone		29 (27.6)
Average number of diuretics used	1.4 (0.5)
Weight control
1x/week		14 (13.3)
Up to 3x/week		05 (4.8)
1x/month		50 (47.6)
Only on medical appointments		36 (34.6)

BSMCS*	Média (dp) †	Md †	Mín/Máx§
Benefits
3. Checking my weight every day will keep me healthy	2.9 (1.6)	3	1 - 5
5. Checking my weight every day will improve my quality of life	3.0 (1.7)	3	1 - 5
11. When I weigh myself I do not care much about my heart disease	3.4 (1.6)	4	1 - 5
15. Checking the swelling of my feet and my legs will improve my quality of life	3.6 (1.4)	4	1 - 5
16. If I weigh myself every day, I reduce my chances of being admitted	3.3 (1.5)	3	1 - 5
17. Checking the swelling of my feet and my legs will keep me healthy	3.8 (1.4)	4	1 - 5
Total	20.2 (5.7)	21	6 - 30
Barriers
1. Checking the swelling of my feet and my legs is unpleasant	3.2 (1.7)	4	1 - 5
2. It takes a long time to weigh myself every day	2.5 (1.6)	2	1 - 5
4. Checking the swelling of my feet and my legs takes a long time	1.5 (0.9)	1	1 - 5
6. Checking my weight every day makes me worried about my disease	2.7 (1.7)	2	1 - 5
7. Checking the swelling of my feet and my legs every day makes me worried about my disease	2.9 (1.7)	3	1 - 5
8. I do not know how to check the swelling of my feet and legs	1.8 (1.3)	1	1 - 5
9. I do not have a scales at home to weigh myself	4.3 (1.3)	5	1 - 5
10. It is unpleasant to weigh myself	2.5 (1.7)	2	1 - 5
12. I do not know how to use the scales to weigh myself	1.6 (1.2)	1	1 - 5
13. I forget to weigh myself every day	3.1 (1.7)	3	1 - 5
14. I cannot see the numbers on the scales to weigh myself	1.6 (1.2)	1	1 - 5
18. I forget to check the swelling of my feet and my legs every day	2.6 (1.7)	2	1 - 5
Total	30.1 (7.1)	29	12 - 60

	Age	Gender	Education	Income	Time with HF	Comorbidities	FC#	LVEF§	Symptoms	Weight control
BSMCS*	r **	r	R	r	r	r	r	r	r	R
				-	-		-
Benefits	0.063	0.003	0.221	0.001	0.018	-0.064	0.039	0.049	-0.022	0.019
	(0.26)	(0.49)	(0.01)	(0.49)	(0.43)	(0.26)	(0.35)	(0.30)	(0.41)	(0.42)
				-
Barriers	- 0.054	0.158	-0.238	0.047	0.003	-0.190	0.079	0.003	0.079	0.245
	(0.29)	(0.05)	(0.00)	(0.32)	(0.49)	(0.03)	(0.20)	(0.48)	(0.21)	(0.00)