Initiation of self-care practices in heart failure patients: a phenomenological study
Downloads
Introduction: The incidence of heart failure continues to rise with advancing age, unabated by advancements in healthcare technology. Patients with heart failure are required to manage their care independently at home for the remainder of their lives. This study aimed to delve into the experiences of heart failure patients regarding self-care management at home.
Methods: Nineteen patients with heart failure were chosen through purposive sampling and thorough interviews were conducted to collect their self-care treatment experiences. Content analysis was carried out to scrutinize the acquired data.
Results: The analysis revealed four themes: patients' perception of heart failure diagnosis, efforts in self-care, readiness for self-care, and adoption of new healthy behaviors in heart failure. Eight categories were formulated within these themes, including "transitioning into a heart failure patient;” "recognizing the need for self-care;” "seeking information and heart failure therapy;” "facilitators and barriers in seeking information regarding self-care;” "social support and belief in engaging in self-care at home;” "self-confidence in engaging in self-care at home;” "efforts to develop self-care strategies;” and "engaging in new healthy behaviors as heart failure patients independently.”
Conclusions: Patients become aware of the necessity for self-care upon experiencing discomfort due to symptoms resulting from their heart failure. Family support and the patient's belief system play pivotal roles in initiating self-care practices at home. Nurses should provide support to patients in fostering self-care practices within their homes.
Agarwal, M. A., Fonarow, G. C. and Ziaeian, B. (2021a) ‘National Trends in Heart Failure Hospitalizations and Readmissions from 2010 to 2017’, JAMA Cardiology, 6(8), pp. 952–956. doi: 10.1001/jamacardio.2020.7472.
Agarwal, M. A., Fonarow, G. C. and Ziaeian, B. (2021b) ‘National Trends in Heart Failure Hospitalizations and Readmissions from 2010 to 2017’, JAMA Cardiology, 6(8), pp. 952–956. doi: 10.1001/jamacardio.2020.7472.
Attaallah, S., Klymko, K. and Hopp, F. P. (2016) ‘Self-Care Among Older Adults With Heart Failure’, Gerontology and Geriatric Medicine, 2, p. 233372141668401. doi: 10.1177/2333721416684013.
Chae, S. et al. (2022) ‘Factors associated with poor self-management documented in home health care narrative notes for patients with heart failure’, Heart and Lung, 55, pp. 148–154. doi: 10.1016/j.hrtlng.2022.05.004.
Chamberlain, L. (2017) ‘Perceived social support and self-care in patients hospitalized with heart failure’, European Journal of Cardiovascular Nursing, 16(8), pp. 753–761. doi: 10.1177/1474515117715842.
Farmer, S. A. et al. (2016) ‘Patient, Caregiver, and Physician Work in Heart Failure Disease Management: A Qualitative Study of Issues That Undermine Wellness’, Mayo Clinic Proceedings, 91(8), pp. 1056–1065. doi: 10.1016/j.mayocp.2016.05.016.
Fivecoat, H. C., Sayers, S. L. and Riegel, B. (2018) ‘Social support predicts self-care confidence in patients with heart failure’, European Journal of Cardiovascular Nursing, 17(7), pp. 598–604. doi: 10.1177/1474515118762800.
Fry, M. et al. (2016a) ‘The implications of living with heart failure; The impact on everyday life, family support, co-morbidities and access to healthcare: A secondary qualitative analysis’, BMC Family Practice, 17(1). doi: 10.1186/s12875-016-0537-5.
Fry, M. et al. (2016b) ‘The implications of living with heart failure; The impact on everyday life, family support, co-morbidities and access to healthcare: A secondary qualitative analysis’, BMC Family Practice, 17(1). doi: 10.1186/s12875-016-0537-5.
Graneheim, U. H., Lindgren, B.-M. and Lundman, B. (2017) ‘Methodological challenges in qualitative content analysis: A discussion paper’, Nurse Education Today, 56, pp. 29–34. doi: 10.1016/j.nedt.2017.06.002.
Graven, L. J. and Grant, J. S. (2014) ‘Social support and self-care behaviors in individuals with heart failure: An integrative review’, International Journal of Nursing Studies, pp. 320–333. doi: 10.1016/j.ijnurstu.2013.06.013.
Hashimoto, S. et al. (2023) ‘Confidence in self-care after heart failure hospitalization’, Journal of Cardiology, 81(1), pp. 42–48. doi: 10.1016/j.jjcc.2022.10.001.
Jaarsma, T. et al. (2013) ‘Comparison of self-care behaviors of heart failure patients in 15 countries worldwide’, Patient Education and Counseling, 92(1), pp. 114–120. doi: 10.1016/j.pec.2013.02.017.
Jaarsma, T. et al. (2017) ‘Factors Related to Self-Care in Heart Failure Patients According to the Middle-Range Theory of Self-Care of Chronic Illness: a Literature Update’, Current Heart Failure Reports. Current Science Inc., pp. 71–77. doi: 10.1007/s11897-017-0324-1.
Jaarsma, T. et al. (2020) ‘Status of theory use in self-care research’, International Journal of Environmental Research and Public Health. MDPI AG, pp. 1–13. doi: 10.3390/ijerph17249480.
Jacobson, A. F. et al. (2018) ‘Patient activation, knowledge, and health literacy association with self-management behaviors in persons with heart failure’, Heart and Lung, 47(5), pp. 447–451. doi: 10.1016/j.hrtlng.2018.05.021.
Jiang, Y. et al. (2023) ‘Relationships of person-related, problem-related, and environment-related factors to self-care behaviours and the mediating role of self-confidence among patients with heart failure: Cross-sectional analysis of structural equation modelling’, International Journal of Nursing Studies, 147. doi: 10.1016/j.ijnurstu.2023.104590.
Jiang, Y. and Wang, W. (2021) ‘Health promotion and self-management among patients with chronic heart failure’, in Health Promotion in Health Care - Vital Theories and Research. Springer International Publishing, pp. 269–285. doi: 10.1007/978-3-030-63135-2_19.
Kessing, D. et al. (2017) ‘Self-care and health-related quality of life in chronic heart failure: A longitudinal analysis’, European Journal of Cardiovascular Nursing, 16(7), pp. 605–613. doi: 10.1177/1474515117702021.
Kim, H. and Cho, M. K. (2021) ‘Factors influencing self-care behavior and treatment adherence in hemodialysis patients’, International Journal of Environmental Research and Public Health, 18(24). doi: 10.3390/ijerph182412934.
Koirala, B. et al. (2018) ‘Factors affecting heart failure self-care: An integrative review’, Heart and Lung. Mosby Inc., pp. 539–545. doi: 10.1016/j.hrtlng.2018.09.004.
Koirala, B. et al. (2020) ‘Heart failure self-care, factors influencing self-care and the relationship with health-related quality of life: A cross-sectional observational study’, Heliyon, 6(2). doi: 10.1016/j.heliyon.2020.e03412.
Lam, C. S. P. et al. (2016) ‘Regional and ethnic differences among patients with heart failure in Asia: The Asian sudden cardiac death in heart failure registry’, European Heart Journal, 37(41), pp. 3141–3153. doi: 10.1093/eurheartj/ehw331.
Lindgren, B. M., Lundman, B. and Graneheim, U. H. (2020) ‘Abstraction and interpretation during the qualitative content analysis process’, International Journal of Nursing Studies. Elsevier Ltd. doi: 10.1016/j.ijnurstu.2020.103632.
MacDonald, M. R. et al. (2020) ‘Regional Variation of Mortality in Heart Failure With Reduced and Preserved Ejection Fraction Across Asia: Outcomes in the ASIAN-HF Registry’, Journal of the American Heart Association, 9(1). doi: 10.1161/JAHA.119.012199.
Massouh, A. et al. (2020) ‘Self-care confidence mediates self-care maintenance and management in patients with heart failure’, Heart and Lung, 49(1), pp. 30–35. doi: 10.1016/j.hrtlng.2019.07.008.
Miles, M. and Huberman, A. (1994) Qualitative Data Analysis: An Expanded Sourcebook. 2nd Ed. Thousand Oaks, CA, USA: Sage Publications.
Nordfonn, O. K., Morken, I. M. and Lunde Husebø, A. M. (2020) ‘A qualitative study of living with the burden from heart failure treatment: Exploring the patient capacity for self-care’, Nursing Open, 7(3), pp. 804–813. doi: 10.1002/nop2.455.
Patrick, M. et al. (2022) ‘Anxiety and depression moderate the relationship between quality of life and self-care in patients with heart failure’, Geriatric Nursing, 44, pp. 54–59. doi: 10.1016/j.gerinurse.2021.12.020.
Reyes, E. B. et al. (2016) ‘Heart failure across Asia: Same healthcare burden but differences in organization of care’, International Journal of Cardiology. Elsevier Ireland Ltd, pp. 163–167. doi: 10.1016/j.ijcard.2016.07.256.
Riegel, B. et al. (2019) ‘Integrating symptoms into the middle-range theory of self-care of chronic illness’, Advances in Nursing Science. Lippincott Williams and Wilkins, pp. 206–215. doi: 10.1097/ANS.0000000000000237.
Riegel, B et al. (2021) Integrating Symptoms Into the Middle-Range Theory of Self-Care of Chronic Illness, Editorial / International Journal of Nursing Studies.
Riegel, Barbara et al. (2021) ‘Self-care research: Where are we now? Where are we going?’, International Journal of Nursing Studies, 116. doi: 10.1016/j.ijnurstu.2019.103402.
Riegel, B., Dickson, V. V. and Faulkner, K. M. (2016) ‘The situation-specific theory of heart failure self-care revised and updated’, Journal of Cardiovascular Nursing, 31(3), pp. 226–235. doi: 10.1097/JCN.0000000000000244.
Savarese, G. et al. (2023) ‘Global burden of heart failure: a comprehensive and updated review of epidemiology’, Cardiovascular research. NLM (Medline), pp. 3272–3287. doi: 10.1093/cvr/cvac013.
Sedlar, N., Lainscak, M. and Farkas, J. (2020) ‘Living with chronic heart failure: Exploring patient, informal caregiver, and healthcare professional perceptions’, International Journal of Environmental Research and Public Health, 17(8). doi: 10.3390/ijerph17082666.
Son, Y. J., Lee, Y. M. and Kim, E. Y. (2019) ‘How do patients develop self-care behaviors to live well with heart failure?: A focus group interview study’, Collegian, 26(4), pp. 448–456. doi: 10.1016/j.colegn.2018.12.004.
Speziale, H. Streubert. and Carpenter, D. Rinaldi. (2011) Qualitative research in nursing : advancing the humanistic imperative. Wolters Kluwer Health/Lippincott Williams & Wilkins.
Su, H. et al. (2023) ‘The Lived Experience of Frailty in Patients Aged 60 Years and Older with Heart Failure: A Qualitative Study’, Asian Nursing Research, 17(4), pp. 191–199. doi: 10.1016/j.anr.2023.07.002.
Vellone, E. et al. (2015) ‘Self-care confidence may be the key: A cross-sectional study on the association between cognition and self-care behaviors in adults with heart failure’, International Journal of Nursing Studies, 52(11), pp. 1705–1713. doi: 10.1016/j.ijnurstu.2015.06.013.
Vellone, E. et al. (2016) ‘Self-care confidence may be more important than cognition to influence self-care behaviors in adults with heart failure: Testing a mediation model’, International Journal of Nursing Studies, 60, pp. 191–199. doi: 10.1016/j.ijnurstu.2016.04.016.
White, M. F., Kirschner, J. and Hamilton, M. A. (2014) ‘Self-care guide for the heart failure patient’, Circulation, 129(3). doi: 10.1161/CIRCULATIONAHA.113.003991.
Copyright (c) 2024 Jurnal Ners
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with Jurnal Ners agree to the following terms:
- Authors transfer the Copyright and grant Jurnal Ners the right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License that allows others to remix, adapt and build upon the work with an acknowledgment of the work's authorship and of the initial publication in Jurnal Ners.
- Authors are permitted to copy and redistribute the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in Jurnal Ners.
Jurnal Ners requires a formal written declaration and transfer of copyright from the author(s) for each article published. We, therefore, ask you to complete and return this form, retaining a copy for your own records. Your cooperation is essential and appreciated. Any delay will result in a delay in publication. The form can be downloaded HERE.