Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Veterans Crisis Line Badge
Go to the ORD website
Go to the QUERI website

2008 HSR&D National Meeting Abstract

Printable View

National Meeting 2008

3005 — Levels of Family Autonomy-Support Climate and Self-care of Veterans with Heart Failure and Diabetes

Sayers SL (Philadelphia VAMC/University of Pennsylvania), Mavandadi S (Philadelphia VAMC/University of Pennsylvania), Jackson-Malik P (Philadelphia VAMC), Stern J (Philadelphia VAMC), Murphy J (Philadelphia VAMC), Wiener MG (Philadelphia VAMC/University of Pennsylvania)

Objectives:
The ways in which family members attempt to support chronically ill patients, while also supporting patients’ autonomy, may have an impact on patients’ self-care. We tested the type of support offered by family members was associated with self-care in veterans with chronic heart failure (CHF), and patients with diabetes mellitus (DM).

Methods:
Outpatients with CHF (N=77, age > 60, 84.3% male) and DM (N=86, age > 60, 70.6% male) from the Philadelphia VA Medical Center were assessed with the SF-12 and the FCQ. Veterans with CHF also were assessed with the Self-care of Heart Failure Index (SCHFI) and veterans with DM were assessed with the Summary of Diabetes Self-care Activities Measure (SDSAM). The FCQ-Autonomy-Support subscale is similar to existing measures of autonomy-support, and the new FCQ-Coercive subscale assesses emotionally coercive strategies to influence patients’ health behaviors (“My family member nags me about taking my medication”). The SCHFI assesses maintenance self-care, management of HF symptoms, and self-care confidence. Most participants had significantly lower SF-12 physical health scores than nonpatient samples (M=35.2, SD=10.1).

Results:
CHF patients with higher autonomy-support scores had significantly better maintenance self-care, r=.23, p < .05, and better mental health, r=.34, p < .05. CHF patients who reported higher levels of coercive support had significantly lower self-care confidence, r=-.21, p < .05. DM patients with higher autonomy-support had higher overall self-care, diet, exercise, and mental health (.20 < r’s < .25, p’s < .05). Patients with higher levels of coercive support had poorer mental health, r=-.32, p < .05.

Implications:
The ways that family members try to help, support, and influence chronically ill patients regarding their self-care may have significant impact on the self-care and mental health of chronically ill patients.

Impacts:
There is significant opportunity to involve family members in learning optimal ways to support and influence veterans' self-care. In turn, it may be possible to improve the quality of life of veterans with chronic illnesses such as CHF and DM.


Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.