Adherence to Self-Care Recommendations and Associated Factors among Adult Heart Failure Patients in West Gojjam Zone Public Hospitals, Northwest Ethiopia

Abstract

Background. Self-care practices are an important part of heart failure patient management and essential to control symptoms of the disease and its exacerbation. However, poor adherence to these self-care behaviors could be associated with an increase in hospitalization, morbidity, and mortality. Even if it is an important part of management for heart failure patients, yet information is not adequate in the study area about adherence to self-care recommendations and associated factors among heart failure patients. Purpose. To assess self-care recommendation adherence and associated factors among heart failure patients in West Gojjam Zone public hospitals. Methods. Institutional-based cross-sectional study was conducted on 304 selected heart failure patients attending follow-up at public hospitals in West Gojjam Zone from March 16 to April 16, 2021. Consecutive sampling technique based on patient arrival with proportional allocation to each hospital was employed to select the study participants. Data were collected through face-to-face interview and reviewing patients’ medical records. Data were entered into EpiData version 3.1 and analyzed using Statistical Package for Social Sciences (SPSS) version 25. Binary logistic regression model was fitted to assess the association between adherence to self-care recommendations and associated factors. $P$ value < 0.05 with 95% confidence interval (CI) was considered to declare a statistically significant association in multivariable logistic regression. Results. In this study, 304 patients participated with a response rate of 97.4%. Only 32.9% of them had good adherence to self-care recommendations. Having good knowledge on heart failure (adjusted odds ratio $\left(\text{AOR}\right)=4.6$ ; 95% CI: 1.82, 11.86), no depression ( $\text{AOR}=6.1$ ; 95% CI: 1.92, 19.37), having strong social support ( $\text{AOR}=3.57$ ; 95% CI: 1.56–8.33), age 30-49 years ( $\text{AOR}=3.37$ ; 95% CI: 1.14, 9.89), and college and above level of education ( $\text{AOR}=6.17$ ; 95% CI: 1.22, 31.25) were factors significantly associated with good adherence to self-care recommendations. Conclusion. This study showed that most of the heart failure patients had poor adherence to self-care recommendations. Policymakers and other stakeholders should develop and implement appropriate strategies to increase patients’ adherence level to self-care recommendations by emphasizing on addressing identified factors.