Abstract 4366742: Factors influencing self-care in elderly patients with concurrent diabetes and coronary artery disease, and their spousal contribution: An Actor-Partner Interdependence Model analysis

Abstract

Background: Self-care in elderly patients with coronary artery disease (CAD) and diabetes is critical for disease management. Spousal support plays a pivotal role in self-care behaviors. This study aimed to examine factors influencing self-care and spousal contributions using the Information-Motivation-Behavioral Skills (IMB) model and the Actor-Partner Interdependence Model (APIM). Methods: A cross-sectional study was conducted with 122 elderly patient-spouse dyads (244 participants) who visited a cardiology outpatient clinic in South Korea between March and September 2023. Data were collected using structured questionnaires and electronic medical records. Analysis included descriptive statistics, Pearson’s correlations, and structural equation modeling using SPSS 27.0 and AMOS 23.0. Results: Correlation analysis revealed significant relationships among disease-related knowledge, health attitudes, self-efficacy for self-care, and self-care behaviors for both patients and spouses. Structural modeling showed that patients’ disease-related knowledge (β = 0.32, p < .001) and self-efficacy (β = 0.21, p = .040) significantly influenced self-care (R2 = 63.5%). Spouses’ knowledge (β = 0.26, p = .015) and self-efficacy (β = 0.50, p < .001) influenced their contributions to patient self-care (R2 = 61.2%). While spouses’ knowledge had no direct effect on patients’ self-care (β = 0.11, p = .254), an indirect effect was found through patients’ self-efficacy (β = 0.13, p = .007). Additionally, spouses’ health attitudes indirectly affected their self-care contributions via self-efficacy (β = 0.17, p = .004). Conclusions: This study highlights the importance of including spouses in self-care interventions for elderly CAD patients with diabetes. Enhancing disease-related knowledge and self-efficacy in both patients and spouses may improve self-care outcomes. Findings support the development of dyadic, patient-centered education and intervention strategies in clinical settings.