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Journal Article

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Publication Source

Journal of Cardiac Failure





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Heart failure (HF) self-care is poor in developed countries like the United States, but little is known about self-care in developing countries.

Methods and Results

A total of 2082 adults from 2 developed (United States and Australia) and 2 developing countries (Thailand and Mexico) were studied in a descriptive, comparative study. Self-care was measured using the Self-Care of HF Index, which provided scores on self-care maintenance, management, and confidence. Data were analyzed using regression analysis after demographic (age, gender, education), clinical (functional status, experience with the diagnosis, comorbid conditions), and setting of enrollment (hospital or clinic) differences were controlled. When adequate self-care was defined as a standardized score ≥70%, self-care was inadequate in most scales in most groups. Self-care maintenance was highest in the Australian sample and lowest in the Thai sample (P < .001). Self-care management was highest in the US sample and lowest in the Thai sample (P < .001). Self-care confidence was highest in the Mexican sample and lowest in the Thai sample (P < .001). Determinants differed for the three types of self-care (eg, experience with HF was associated only with self-care maintenance).


Interventions aimed at improving self-care are greatly needed in both the developed and the developing countries studied.

Copyright/Permission Statement

NOTICE: This is the author’s version of a work that was accepted for publication in Journal of Cardiac Failure. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms, may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Cardiac Failure, 2009, 15(6), 508-516, doi: 10.1016/j.cardfail.2009.01.009.


self-management, treatment adherence, hispanic, minority groups



Date Posted: 01 June 2016

This document has been peer reviewed.