Relationships among self-care behaviors, anxiety, depression, and religious attitudes in patients with heart failure

Background: Heart failure (HF) is a chronic condition requiring effective self-care to improve clinical outcomes and quality of life. Psychological factors such as anxiety and depression, as well as religious attitudes, may influence self-care behaviors, but evidence remains inconsistent. Thus, this study aimed to examine the relationships among self-care, religious attitudes, anxiety, and depression among patients with HF. Methods: This cross-sectional study involved recruiting ۱۱۴ HF patients through convenience sampling at two educational hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences in Iran in ۲۰۲۳. Participants completed a demographic questionnaire, the European Self-Care Behavior Questionnaire (ESCBQ), the Hospital Anxiety and Depression Scale (HADS), and a Religious Attitude Questionnaire. Data were analyzed using SPSS v.۲۲ running t-tests, one-way ANOVA, Chi-square tests, Pearson correlations, and multiple and simple regression analyses. Results: Participants had a mean age of ۵۵.۴۷±۱۳.۹۰ years, and hypertension was the most common comorbidity (۱۵.۸%). The mean self-care score was ۳۸.۹۲ ± ۷.۸۶ (moderate level; higher scores indicate poorer self-care). Their anxiety (۹.۸۳±۴.۲۲) and depression (۹.۶۱±۴.۷۵) were at moderate levels, while their religious attitudes averaged ۶۹.۰۵ ± ۱۰.۰۸. Self-care behaviors were significantly negatively correlated with both anxiety and depression (p<۰.۰۵), but not with religious attitude. Multiple regression analysis revealed anxiety as the only independent predictor of self-care (β=۰.۵۰, p<۰.۰۰۱). Conclusion: Anxiety is a key determinant of self-care in patients with HF, whereas depression has an indirect effect, and religious attitudes show no significant influence. Interventions focusing on anxiety reduction and psychological support may prove effective in enhancing self-care behaviors and improving clinical outcomes in this population.

Keywords:

Heart failure , Self-care , Depression , Anxiety , Attitude