Psychological determinants of heart failure self-care: Systematic review and meta-analysis

Research output: Contribution to journalReview articleScientificpeer-review

Abstract

Objective: 
Psychological distress has been associated with poor outcomes in patients with chronic heart failure (HF), which is assumed to be partly due to poor HF self-care behavior. This systematic review and meta-analysis describes the current evidence concerning psychological determinants of self-care in patients with chronic HF.
Methods: 
Eligible studies were systematically identified by searching electronic databases PubMed, PsycINFO, and the Conference Proceedings Citation Index (Web of Science) for relevant literature (1980–October 17, 2014). Study quality was assessed according to the level of risk of bias. Quantitative data were pooled using random-effects models.
Results: 
Sixty-five studies were identified for inclusion that varied considerably with respect to sample and study characteristics. Risk of bias was high in the reviewed studies and most problematic with regard to selection bias (67%). Depression (r = −0.19, p < .001), self-efficacy (r = 0.37, p < .001), and mental well-being (r = 0.14, p = .030) were significantly associated with self-reported self-care. Anxiety was not significantly associated with either self-reported (r = −0.18, p = .24) or objective self-care (r = −0.04, p = .79), neither was depression associated with objectively measured medication adherence (r = −0.05, p = .44).
Conclusions: 
Psychological factors (depression, self-efficacy, and mental well-being) were associated with specific self-care facets in patients with chronic HF. These associations were predominantly observed with self-reported indices of self-care and not objective indices. Methodological heterogeneity and limitations preclude definite conclusions about the association between psychological factors and self-care and should be addressed in future research.
Original languageEnglish
Pages (from-to)412-431
JournalPsychosomatic Medicine
Volume78
Issue number4
DOIs
Publication statusPublished - 2016

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Selection Bias
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@article{57116ef7aa9744168a39ad112c95af97,
title = "Psychological determinants of heart failure self-care: Systematic review and meta-analysis",
abstract = "Objective: Psychological distress has been associated with poor outcomes in patients with chronic heart failure (HF), which is assumed to be partly due to poor HF self-care behavior. This systematic review and meta-analysis describes the current evidence concerning psychological determinants of self-care in patients with chronic HF.Methods: Eligible studies were systematically identified by searching electronic databases PubMed, PsycINFO, and the Conference Proceedings Citation Index (Web of Science) for relevant literature (1980–October 17, 2014). Study quality was assessed according to the level of risk of bias. Quantitative data were pooled using random-effects models.Results: Sixty-five studies were identified for inclusion that varied considerably with respect to sample and study characteristics. Risk of bias was high in the reviewed studies and most problematic with regard to selection bias (67{\%}). Depression (r = −0.19, p < .001), self-efficacy (r = 0.37, p < .001), and mental well-being (r = 0.14, p = .030) were significantly associated with self-reported self-care. Anxiety was not significantly associated with either self-reported (r = −0.18, p = .24) or objective self-care (r = −0.04, p = .79), neither was depression associated with objectively measured medication adherence (r = −0.05, p = .44).Conclusions: Psychological factors (depression, self-efficacy, and mental well-being) were associated with specific self-care facets in patients with chronic HF. These associations were predominantly observed with self-reported indices of self-care and not objective indices. Methodological heterogeneity and limitations preclude definite conclusions about the association between psychological factors and self-care and should be addressed in future research.",
author = "D.E.F. Kessing and J. Denollet and J.W.M.G. Widdershoven and N. Kupper",
year = "2016",
doi = "10.1097/PSY.0000000000000270",
language = "English",
volume = "78",
pages = "412--431",
journal = "Psychosomatic Medicine",
issn = "0033-3174",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

Psychological determinants of heart failure self-care : Systematic review and meta-analysis. / Kessing, D.E.F.; Denollet, J.; Widdershoven, J.W.M.G.; Kupper, N.

In: Psychosomatic Medicine, Vol. 78, No. 4, 2016, p. 412-431.

Research output: Contribution to journalReview articleScientificpeer-review

TY - JOUR

T1 - Psychological determinants of heart failure self-care

T2 - Systematic review and meta-analysis

AU - Kessing, D.E.F.

AU - Denollet, J.

AU - Widdershoven, J.W.M.G.

AU - Kupper, N.

PY - 2016

Y1 - 2016

N2 - Objective: Psychological distress has been associated with poor outcomes in patients with chronic heart failure (HF), which is assumed to be partly due to poor HF self-care behavior. This systematic review and meta-analysis describes the current evidence concerning psychological determinants of self-care in patients with chronic HF.Methods: Eligible studies were systematically identified by searching electronic databases PubMed, PsycINFO, and the Conference Proceedings Citation Index (Web of Science) for relevant literature (1980–October 17, 2014). Study quality was assessed according to the level of risk of bias. Quantitative data were pooled using random-effects models.Results: Sixty-five studies were identified for inclusion that varied considerably with respect to sample and study characteristics. Risk of bias was high in the reviewed studies and most problematic with regard to selection bias (67%). Depression (r = −0.19, p < .001), self-efficacy (r = 0.37, p < .001), and mental well-being (r = 0.14, p = .030) were significantly associated with self-reported self-care. Anxiety was not significantly associated with either self-reported (r = −0.18, p = .24) or objective self-care (r = −0.04, p = .79), neither was depression associated with objectively measured medication adherence (r = −0.05, p = .44).Conclusions: Psychological factors (depression, self-efficacy, and mental well-being) were associated with specific self-care facets in patients with chronic HF. These associations were predominantly observed with self-reported indices of self-care and not objective indices. Methodological heterogeneity and limitations preclude definite conclusions about the association between psychological factors and self-care and should be addressed in future research.

AB - Objective: Psychological distress has been associated with poor outcomes in patients with chronic heart failure (HF), which is assumed to be partly due to poor HF self-care behavior. This systematic review and meta-analysis describes the current evidence concerning psychological determinants of self-care in patients with chronic HF.Methods: Eligible studies were systematically identified by searching electronic databases PubMed, PsycINFO, and the Conference Proceedings Citation Index (Web of Science) for relevant literature (1980–October 17, 2014). Study quality was assessed according to the level of risk of bias. Quantitative data were pooled using random-effects models.Results: Sixty-five studies were identified for inclusion that varied considerably with respect to sample and study characteristics. Risk of bias was high in the reviewed studies and most problematic with regard to selection bias (67%). Depression (r = −0.19, p < .001), self-efficacy (r = 0.37, p < .001), and mental well-being (r = 0.14, p = .030) were significantly associated with self-reported self-care. Anxiety was not significantly associated with either self-reported (r = −0.18, p = .24) or objective self-care (r = −0.04, p = .79), neither was depression associated with objectively measured medication adherence (r = −0.05, p = .44).Conclusions: Psychological factors (depression, self-efficacy, and mental well-being) were associated with specific self-care facets in patients with chronic HF. These associations were predominantly observed with self-reported indices of self-care and not objective indices. Methodological heterogeneity and limitations preclude definite conclusions about the association between psychological factors and self-care and should be addressed in future research.

U2 - 10.1097/PSY.0000000000000270

DO - 10.1097/PSY.0000000000000270

M3 - Review article

VL - 78

SP - 412

EP - 431

JO - Psychosomatic Medicine

JF - Psychosomatic Medicine

SN - 0033-3174

IS - 4

ER -