Background: Sixty-four million people around the world have heart failure. Self-care, a naturalistic patient-centered decision-making process, is a critical component of heart failure management potentially influenced by socioecological determinants of health. While research has established a connection between certain socioecological determinants of health and heart failure self-care, such as health literacy and social support, there is little known about food insecurity and its’ relationship to self-care. Purpose: To determine the relationship between health literacy, social support, food insecurity and heart failure self-care. Methods: A cross-sectional, descriptive, correlational survey of 88 participants with heart failure was conducted. Multiple correlation and standard multiple regression were used to answer research questions. Results: Emotional support was more significantly correlated to all three heart failure self-care measures than instrumental support. Emotional support, food security, and health literacy, when combined, significantly contributed 15% of the total variance in self-care maintenance (p=.003), 22% of the total variance in symptom perception (p<.001), and 11% of the total variance in self-care management (p=.02). When combined, the impact of instrumental support, food security, and health literacy significantly contributed 12% of the total variance in self-care maintenance (p=.013), 19% of the total variance in symptom perception (p<.001), 10% of the total variance in self-care management (p=.04). Conclusion: This study contributes to the limited knowledge of the impact of food insecurity and types of social support in self-care practices. Food insecurity and health literacy, though they did not independently correlate to self-care, significantly influenced self-care when combined with emotional or instrumental support. Emotional support may influence a wider range of self-care behaviors than other types of social support.
- Exploring the relationship between socioecological determinants of health and heart failure self-care
- Michelle D. Whyte
- 0000-0002-2675-2441
- Kristen Sethares (Advisor) - University of Massachusetts Dartmouth, Department of Adult NursingJennifer Dunbar Viveiros (Committee Member) - University of Massachusetts Dartmouth, Department of Adult NursingNancy Morris (Committee Member) - University of Massachusetts Chan Medical SchoolMarybeth Vieira (Committee Member) - Johnson & Wales University
- ix, 67 pages
- Section 1: Introduction -- Section 2: Problem statement -- Background and significance -- Statement of the problem -- Theoretical basis of the study -- Purpose of the study -- Research questions -- Summary of methodology -- Section 3: Literature review -- Introduction -- Theoretical perspectives -- Empirical literature -- Section 4: Methods -- Research design -- Setting -- Sample -- Instruments -- Data analysis -- Ethical considerations -- Limitations -- Section 5: Executive summary -- Summary of dissertation process -- Study findings -- Conclusions -- Lessons learned -- Plans for dissemination -- References.
- Includes bibliographical references (pages 34-50).
- University of Massachusetts Dartmouth
- Doctor of Philosophy (PHD)
- Nursing
- College of Nursing and Health Sciences
- English
- Dissertation
- Copyright 2026 Michelle D. Whyte
- https://doi.org/10.62791/20536
- 9914528695501301