Authors:

E Kartamyscheva¹ , YU Lopatin¹ , ¹Volgograd State Medical University, Department of Cardiology - Volgograd - Russian Federation ,

Background. Self-care is an important factor providing a successful management of patients with heart failure (HF). Several tools are using for the measurement of self-care in HF. 
Purpose. The purpose of our study was to compare Russian versions of the European Heart Failure Self-Care Behavior Scale_9 (EHFScBS_9) and the Self-care of Heart Failure Index, version 6.2 (SCHFI) in the assessment of the self-care in hospitalized HF patients.
Methods. 50 hospitalized patients with HF (NYHA I-III), mean age 62.2 ± 9.6 years, 56% of them were male, mean left ventricular ejection fraction 52.1 ± 10.3% were included into the study.  The management of patients with HF, including patient’s education was performed according to the current ESC/HFA Guidelines 2016 and the Russian Guidelines 2017. The level of self-care was assessed on admission and before discharge from the hospital by using EHFScBS_9 and SCHFI.
Results. The coefficient a-Cronbach for EHFScBS_9 was 0.788 on admission and 0.798 at discharge from the hospital. Test-retest reliability of this scale was 0.892 (p<0.01).  The coefficient a- Cronbach for SCHFI was 0.722 on admission and 0.785 at discharge from the hospital, test-retest reliability was 0.832 (p<0.01). Both scales demonstrated an improvement in the ability to self-care in hospitalized HF patients. Total score of the EHFScBS_9 was decreased from 22.0±8.6 on admission to 20.4±7.5 at discharge from the hospital (p<0.01). The total score of the SCHFI was increased from 129.7±38.9 on admission to 143.9±41.4 at discharge from the hospital (p <0.01). The greatest improvement of the EHFScBS_9 was noted in items: "if my shortness of breath increases I contact my doctor or nurse" from 2.3±1.5 initially to 2.0±1.3 at discharge from the hospital (p<0.01); "if my feet/legs become more swollen than usual I contact my doctor or nurse" from 2.5±1.6 to 2.2±1.5 (p<0.01). The greatest improvement of the SCHFI was observed in items: "check your ankles for swelling" from 2.5 ± 1.0 to 2.8 ± 0.9 (p<0.01), "reduce your fluid intake" from 2.4 ± 1.0 to 2.8 ± 0.9 (p<0.01) and "take an extra water pill" from 2.3±1.4 to 2.7±1.1 (p<0.01), "do something that will relieve your symptoms" from 2.2 ± 0.9 to 2.5 ± 0.8 (p<0.01), respectively. Analysis of concurrent validity showed an average inverse correlation between the scales, both on admission (r= –0.309; p=0.029) and at discharge from the hospital (r= –0.434; p<0.01). 
Conclusion. Russian versions of the European Heart Failure Self-Care Behavior Scale and the Self-care of Heart Failure Index are effective tools for the assessment of self-care in patients with heart failure, and can be used both in clinical studies and in real clinical practice.