cognitive impairment, heart failure, self-care



  1. Lee, Kyoung Suk PhD, MPH, RN
  2. Choi, Jin-Oh MD, PhD
  3. Jeon, Eun-Seok MD, PhD
  4. Park, Jae-Hyeong MD, PhD
  5. Jung, Mi Sook PhD, RN
  6. Lee, Zian MSN, RN
  7. Lee, Hyeong Suk RN
  8. Yoo, Hye Jin PhD, RN


Background: A decline in cognition may limit patients' ability to effectively engage in self-care in those with heart failure (HF). However, several studies have shown no difference in self-care between HF patients with and without cognitive impairment. This may indicate that there are more salient factors associated with self-care in HF patients with cognitive impairment compared with those without cognitive impairment.


Objective: The aim of this study was to explore which factors are related to self-care based on the presence and absence of mild cognitive impairment (MCI) among patients with HF.


Methods: Patients with HF were recruited from outpatient settings. The Montreal Cognitive Assessment was used to screen for MCI. Self-care was measured with the Self-care of HF Index v.6.2. Two separate stepwise linear regressions were performed to identify which factors (HF knowledge, perceived control, functional status, multimorbidity, executive function, and social support) predicted self-care in HF patients with and without MCI.


Results: Of the 132 patients in this study, 36 (27.3%) had MCI. Self-care maintenance and management were associated with social support ([beta] = 0.489) and executive function ([beta] = 0.484), respectively, in patients with MCI. Perceived control was associated with both self-care maintenance and management in patients without MCI ([beta]s = 0.404 and 0.262, respectively).


Conclusion: We found that social support and executive function were associated with self-care in HF patients with MCI, whereas perceived control was associated with self-care in HF patients with intact cognition. Clinicians should develop tailored interventions to enhance self-care by considering the distinct factors associated with self-care based on the presence or absence of MCI.