Investigation of the relationship between fatigue, fear of falling and care dependency in patients with heart failure

Objective: This descriptive and cross-sectional study was conducted to examine the relationship between fatigue, fear of falling, and care dependency in patients with heart failure. Method: The study was carried out with 221 patients who met the inclusion criteria at the Cardiology Clinic of Akdeniz University Hospital between August 2024 and January 2025. Research data were collected using the "Personal Information Form," the "Fatigue Severity Scale," the "Falls Efficacy Scale-International," and the "Care Dependency Scale." Data were analyzed using t-tests, ANOVA test, and Pearson correlation analysis, while structural relationships between the concepts were evaluated through Structural Equation Modeling. The significance level was set at p<0.05. Results: Among the patients with heart failure, 53.8% were male, with a mean age of 67.30±14.16 years. It was determined that 95% of the individuals experienced fear of falling, 92.8% experienced severe fatigue, and care dependency was at a moderate level. There was a moderate relationship between fatigue and care dependency (r=-0.519, p<0.0001) and fear of falling (r=0.519, p<0.0001), and a strong relationship between fear of falling and care dependency (r=-0.777, p<0.0001). According to the structural equation model analysis, fatigue significantly affected fear of falling (β=0.5197, p<0.0001), and fatigue and fear of falling significantly affected care dependency (β=-0.1573, p=0.0012; β=-0.6950, p<0.0001). It was determined that fear of falling had a mediating effect on the relationship between fatigue and care dependency. Conclusion: A relationship was found among fatigue, fear of falling, and care dependency in individuals with heart failure. Further studies are recommended to examine the levels of fatigue, fear of falling and care dependency together, to plan nursing interventions accordingly and to increase the level of evidence. Key words: Care dependency, fear of falling, nursing, heart failure, fatigue