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heart failure, perceived control, self-care, symptom status



  1. Lin, Chin-Yen BSN, RN
  2. Miller, Jennifer L. PhD, RN
  3. Lennie, Terry A. PhD, RN, FAHA, FAAN
  4. Biddle, Martha J. PhD, RN, APRN, CCNS, FAHA
  5. Mudd-Martin, Gia PhD, MPH, RN, FAHA
  6. Hammash, Muna PhD, RN
  7. Moser, Debra K. PhD, RN, FAHA, FAAN


Background: Symptom status is an important indicator of disease progression in patients with heart failure (HF). Perceived control is a target of most self-care interventions and is associated with better outcomes in HF; however, little is known about the relationship between perceived control and symptom status in patients with HF.


Objective: The aims of this study were to (1) determine the relationship of perceived control to HF symptom status and (2) examine the associations of perceived control to self-care and of self-care to symptom status.


Methods: A total of 115 patients with HF were included. Data on symptom status (Memorial Symptom Assessment Scale-HF), perceived control (Control Attitudes Scale-Revised), and self-care (Self-Care of Heart Failure Index) were collected. Other covariates included were age, gender, New York Heart Association class, comorbidity burden, and depressive symptoms. Multiple regression analyses were performed to analyze the data.


Results: Lower perceived control predicted worse symptom status after controlling for covariates (P = .009). Other covariates predictive of worse symptom status were younger age, New York Heart Association class III/IV, and higher levels of depressive symptoms. Higher levels of perceived control were associated with better self-care (P = .044). Better self-care was associated with better symptom status (P = .038).


Conclusions: Lower levels of perceived control were independently associated with worse symptom status in patients with HF. Intervention strategies targeting perceived control should be tested to determine whether they could improve symptom status.