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Relationships between illness representations, treatment beliefs and the performance of self-care in heart failure: a cross-sectional survey

Background: Self-care is a key principle in the management of chronic heart failure (HF). The common sense model (CSM) of illness cognitions and behaviour provides a theoretical framework within which relationships between beliefs and behaviour can be examined. Aim: The aim of this study was to determine relationships between illness representations, treatment beliefs and the performance of self-care in community HF patients. Methods: A cross-sectional survey was carried out in 169 patients with HF in South East England. Illness representations, treatment beliefs and self-care were measured using an adapted Revised Illness Perception Questionnaire (IPQ-R); the Beliefs about Medicines Questionnaire (BMQ) and the Looking After Yourself with Heart Failure Questionnaire (LAYHFQ), according to the CSM. Relationships between these specific concepts were determined using Pearson’s correlation co-efficients (r) and stepwise multiple regression. Results: Perceived medication knowledge (r=0.51, p≤0.01), beliefs about the necessity of medication (r=0.45, p≤0.01) and illness coherence (r=0.39, p≤0.01) were moderately correlated with self-care. Multiple regression analysis revealed that 46% of the variance in self-care could be explained by illness representations and treatment beliefs (adjusted R2=0.46, F=9.93, p=0.00). Three factors were significant predictors of self-care – medication knowledge (β=0.319, p=0.003), a belief in the illness having serious consequences (β=0.258, p=0.008) and the impact of medication use on lifestyle (β= −0.231, p=0.03). Conclusion: Illness representations and treatment beliefs should be explored in patients with HF in order to inform the development of targeted interventions designed to correct misconceptions and enhance self-care. This has the potential to improve clinical outcomes in this population.