Graduation Semester and Year
Fall 2025
Language
English
Document Type
Dissertation
Degree Name
Doctor of Philosophy in Nursing
Department
Nursing
First Advisor
Mari Tietze
Second Advisor
Deborah Behan
Third Advisor
Daisha Cipher
Fourth Advisor
Jessica Smith
Abstract
Heart failure (HF) risks increase as patients age, with most of the HF patients having at least one chronic condition and 40% having two or more. Further confounding the HF morbidity and chronic medical conditions are psychiatric conditions like depression and anxiety. For most Americans with HF, managing the diagnosis and chronic conditions can be overwhelming. To formalize the definitions of HF disease management, the concepts of self-care from the situation-specific theory of HF self-care (SST-HFSC) were applied.
The medical complexity of HF self-care during the pandemic was shown to vary based on the US region where the individual resided. Because the risk of HF was identified early in the pandemic as a high-risk diagnosis for COVID-19 complications, individuals with HF avoided hospitalizations and clinic visits. Due to the delay in treatment, the individuals with HF demonstrated an increased risk of out-of-hospital cardiac arrest, required mechanical ventilation, and a higher risk of death based on the region.
To get a better understanding of self-care behaviors before COVID-19 and after the infection risk declined, the study examined the regional and yearly differences between self-care behaviors in Americans with HF, diabetes mellitus (DM), hypertension (HTN), and depression between the years 2019 and 2022. The data source was the Medical Expenditure Panel Survey (MEPS), a yearly survey conducted through the auspices of the Agency for Healthcare Research and Quality. The study was a retrospective comparative cohort secondary analysis using the 2019 MEPS and the 2022 MEPS data to contrast regional self-care behavior before and after the COVID-19 pandemic.
The 2019 MEPS served as the baseline before the height of the COVID-19 pandemic and focused on the self-care behaviors of American respondents with HF, DM, HTN, and depression. The comparison of the 2022 MEPS highlighted the self-care behaviors of Americans with HF, DM, HTN, and depression as the pervasiveness of COVID-19 diminished in the United States. Results demonstrated significant differences between self-care behaviors during the two years and between the regions. The results highlighted the Self-Care Management proxy variables between 2019 and 2022. Regional differences highlighted the differences between the West and the other regions: the Northeast, the Midwest, and the South.
Keywords
Heart failure, MEPS, self-care behaviors, diabetes mellitus, hypertension, depression, Situation-Specific Theory of Heart Failure Self-Care
Disciplines
Nursing
License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.
Recommended Citation
Wendt, Gretchen K., "REGIONALITY IN HEART FAILURE SELF-CARE BEHAVIORS USING THE MEDICAL EXPENDITURE PANEL SURVEY" (2025). Nursing Dissertations. 136.
https://mavmatrix.uta.edu/nursing_dissertations/136