Empowerment trajectories in patients with chronic heart failure: a descriptive correlational study

Abstract

Aims: Patient empowerment is a key factor in the management of chronic heart failure (HF), as it enables individuals to better understand and manage their condition, improve outcomes, and reduce the risk of decompensation. This study aims to identify predictors of baseline empowerment and its changes (improvement or deterioration) in patients with HF. Examining empowerment trajectories can help identify patients at risk of deterioration and support the design of tailored interventions.

Methods and results: Sociodemographic, clinical, psychosocial, HRQoL, self-care, and empowerment questionnaire data were collected at baseline and at 12 weeks. Empowerment evolution was calculated as the difference between baseline and 12-week empowerment values, categorized as improvement, no change, or deterioration. The sample was analysed descriptively, and bivariate, linear, and regression models were applied. Factors associated with lower baseline empowerment included functional class (P = 0.01) and anxiety (P = 0.01). Predictors of empowerment deterioration were age (P = 0.003), functional class (P = 0.037), and dependency level (P = 0.047). Regression analyses showed that advanced age (P < 0.03), cognitive status (P = 0.006), and level of dependency (P = 0.002) were the main determinants of deterioration in empowerment over time.

Conclusion: Poor functional status and anxiety were associated with lower baseline empowerment levels. Advanced age, cognitive decline, and higher dependency were significant predictors of worsening empowerment over time. These findings emphasize the need for tailored interventions to address functional, psychological, and cognitive challenges in patients with HF to support their empowerment and improve health outcomes.

Keywords: Chronic heart failure; Empowerment; Nurses; Patient-reported outcomes; Quality of life; Self-Care.