ArticleInternational journal of nursing studies advances2026
The association between social capital and self-care behaviors in patients with heart failure: A cross-sectional study.
Article in International journal of nursing studies advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Alongside pharmacological management, self-care is crucial for reducing morbidity and rehospitalization in heart failure patients. Previous studies have identified various medical, individual, and system barriers, particularly low social support. While social support focuses on the immediate patient environment (microsystem), social capital includes broader factors (exosystem, macrosystem), which remain unexplored in heart failure self-care. Methods: A multicenter cross-sectional study involving 157 heart failure patients (left ventricular ejection fraction≤50 or diastolic dysfunction) was conducted using stratified multistage sampling from hospitals and clinics affiliated with Shiraz University of Medical Sciences. Heart failure self-care was assessed using the Self-Care of Heart Failure Index (version 7.2), and social capital was measured via the 36-item Onyx and Bullen scale. Generalized linear models with leave-one-out cross-validation identified independent predictors of adequate self-care (score≥70), adjusting for demographic, clinical, and behavioral covariates, including self-care confidence. Results: Social capital scored relatively low to moderate (standardized median: 47.222, 95% confidence interval [95%CI]: 35.484-58.065). Higher social capital was positively correlated with self-care maintenance ( Conclusions: Notably, most patients with heart failure exhibited inadequate self-care across all domains. Social proactivity and community participation, scarcely studied yet potentially modifiable aspects of social capital, were positively associated with self-care behaviors. From these findings, we suggest that integrating social capital assessments into multidisciplinary heart failure care can help nurses tailor behavioral interventions and strengthen community-based support strategies. Future interventional trials should evaluate targeted social-capital interventions as a novel adjunct to nursing-led self-care support in heart-failure patients. Registration: IR.SUMS.MED.REC.1404.205.
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