Status and influencing factors of self-care among patients with chronic heart failure and their spouses from a dual perspective: a cross-sectional study

Abstract

Objective To investigate the current status and influencing factors of self-care among chronic heart failure (CHF) patients and their spouses in China from a dyadic perspective, and to explore the interaction mechanisms between actor and partner variables. Methods Using a cross-sectional design, 204 dyads of CHF patients and their spouses were recruited from a tertiary hospital in Zhejiang Province. Data were collected via an online questionnaire platform, with trained investigators assisting elderly participants unable to complete the survey on their own. Questionnaires used in this study included the general information questionnaire, Self-Care of Heart Failure Index, Health Literacy Scale, Mutuality Scale, and Social Support Rating Scale. Data were analyzed using multiple linear regression and the Actor-Partner Interdependence Model. Results Median scores of all three self-care subscales for both patients and spouses were below the adequacy threshold of 70 points, with the Self-care Management dimension presenting the lowest subscale scores. Patient self-care scores were significantly higher than spouse contribution scores (P < 0.001). Multiple regression indicated that mutuality and CHF training experience were positively associated with self-care for the dyads. APIM analysis revealed that patient health literacy and spouse mutuality had significant actor-partner effects, influencing both their own and their partner's self-care. Conclusion Self-care levels in CHF dyads were generally low. Clinical interventions should shift from an individualistic focus to a dyadic approach, specifically targeting the enhancement of patient health literacy and spouse mutuality to improve overall family-based disease management.