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PLoS One. 2015 Jun 19;10(6):e0130973. doi: 10.1371/journal.pone.0130973. eCollection 2015.

The Effect of Self-Care Education on the Awareness, Attitude, and Adherence to Self-Care Behaviors in Hospitalized Patients Due to Heart Failure with and without Depression.

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Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
Faculty of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran.



Cardiovascular diseases are among somatic disorders and psychological factors affect their onset, exacerbation, and treatment. This study was conducted on the hospitalized patients who had heart failure with and without depression. The study criteria was to evaluate the effect of self-care education on awareness, attitude, and adherence to self-care behaviors on these patients.


In this quasi-experimental study, seventy patients with heart failure that met the inclusion criteria were recruited through purposive sampling method. They were assigned in to two equal size groups regarding their depression status. First, the eligible patients were selected; then Beck Depression Inventory was done on the patients followed by examination by the clinical psychologist. Patients with average and higher scores were classified in the depressed group and others who got lower than average scores were classified as the non -depressed group. A questionnaire containing items related to awareness, attitude, and adherence to self-care behaviors was used to collect the data. First, self-care behavior was determined and then a four-sessions of educational intervention were held individually for both groups. The second round of questionnaires were completed at patients' home twelve weeks after the discharge. The Collected data was analyzed using independent-samples and paired-sample t tests, Chi square, and statistical analysis of covariance (ANCOVA) tests through SPSS (version 21, SPSS Inc., Chicago, IL, USA).


After the educational sessions, the statistical analysis showed significant differences in the mean scores of awareness, attitude, and adherence to self-care behaviors between the two groups (P<0.0001).


Self-care behavior education had lower effects on the depressed patients with heart failure. Therefore, before providing education for these patients, it is necessary to consider their psychological problems such as depression.

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