Influencing factors of self-regulation fatigue in older adults with chronic heart failure: A structural equation model.

OBJECTIVE

This study aims to systematically construct a structural equation model of self-regulation fatigue in older adults with chronic heart failure based on the social cognitive theory of self-regulation.

METHODS

This study utilized a convenience sampling method to enroll 338 older adults with chronic heart failure from a tertiary hospital in Wuxi during the period spanning November 2023 to May 2024. The participants completed surveys using the Social Support Rating Scale, Memorial Symptom Assessment Scale-Heart Failure, Connor-Davidson Resilience Scale, Ruminative Response Scale, and Self-Regulation Fatigue Scale.

RESULTS

The mean score for self-regulation fatigue was 39.01 ± 8.40. Bootstrap analysis revealed that symptom burden, psychological resilience, and rumination exerted significant mediating effects in the relationship between social support and self-regulatory fatigue (95 % CI: -0.127 to -0.012). The total effect of social support on self-regulatory fatigue was significant (P < 0.001, 95 % CI: -0.605 to -0.422), with a direct effect of (P < 0.001, 95 % CI: -0.344 to -0.199) and an indirect effect of (P < 0.001, 95 % CI: -0.347 to -0.144). The mediating effects accounted for 52.2 % of the total effect.

CONCLUSION

Patients with chronic heart failure experience a high level of self-regulatory fatigue, which warrants further improvement. Healthcare providers should promptly assess and address patients' symptom burden, guide them toward adopting a positive outlook, and provide psychological support and stress-coping strategies. At the same time, reducing negative coping tendencies and helping patients recognize and utilize social support can foster accurate illness perceptions, thereby alleviating self-regulatory fatigue.