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Current Heart Failure Reports
Published in: Current Heart Failure Reports 2/2017

Open Access 01-04-2017 | Self-Care and Health Outcomes (R Gallagher and R Clark, Section Editors)

Factors Related to Self-Care in Heart Failure Patients According to the Middle-Range Theory of Self-Care of Chronic Illness: a Literature Update

Authors: Tiny Jaarsma, Jan Cameron, Barbara Riegel, Anna Stromberg

Published in: Current Heart Failure Reports | Issue 2/2017

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Abstract

Purpose of the Review

As described in the theory of self-care in chronic illness, there is a wide range of factors that can influence self-care behavior. The purpose of this paper is to summarize the recent heart failure literature on these related factors in order to provide an overview on which factors might be suitable to be considered to make self-care interventions more successful.

Recent Findings

Recent studies in heart failure patients confirm that factors described in the theory of self-care of chronic illness are relevant for heart failure patients.

Summary

Experiences and skills, motivation, habits, cultural beliefs and values, functional and cognitive abilities, confidence, and support and access to care are all important to consider when developing or improving interventions for patients with heart failure and their families. Additional personal and contextual factors that might influence self-care need to be explored and included in future studies and theory development efforts.
Literature
1.
•• Riegel B, Jaarsma T, Strömberg A. A middle-range theory of self-care of chronic illness. Adv Nurs Sci. 2012;35:194–204. This article describes a middle-range theory of self-care that addresses the process of maintaining health with health promoting practices within the context of the management required of a chronic illness.CrossRef
2.
Lee KS, Lennie TA, Dunbar SB, Pressler SJ, Heo S, Song EK, et al. The association between regular symptom monitoring and self-care management in patients with heart failure. J Cardiovasc Nurs. 2015;30:145–51.CrossRefPubMedPubMedCentral
3.
van der Wal MH, van Veldhuisen DJ, Veeger NJ, Rutten FH, Jaarsma T. Compliance with non-pharmacological recommendations and outcome in heart failure patients. Eur Heart J. 2010;31:1486–93.CrossRefPubMed
4.
Vellone E, Fida R, Ghezzi V, D’Agostino F, Biagioli V, Paturzo M, et al. Patterns of self-care in adults with heart failure and their associations with sociodemographic and clinical characteristics, quality of life, and hospitalizations: a cluster analysis. J Cardiovasc Nurs. 2016.
5.
•• Riegel B, Dickson VV, Faulkner KM. The situation-specific theory of heart failure self-care: revised and updated. J Cardiovasc Nurs. 2016;31:226–35. This article describes a situation-specific Theory of self-care that focusses specially on heart failure.CrossRefPubMed
6.
•• Jonkman NH, Westland H, Groenwold RH, Ågren S, Atienza F, Blue L, et al. Do self-management interventions work in patients with heart failure? An Individual Patient Data Meta-Analysis. Circulation. 2016;133:1189–98. Recent well performed individual patient data meta-analysis with data from 20 studies, representing 5624 patients.CrossRefPubMed
7.
Dickson V, Riegel B. Are we teaching what patients need to know? Building skills in heart failure self-care. Heart Lung. 2009;38:253–61.CrossRefPubMed
8.
Matsuoka S, Tsuchihashi-Makaya M, Kayane T, Yamada M, Wakabayashi R, Kato NP, et al. Health literacy is independently associated with self-care behavior in patients with heart failure. Patient Educ Couns. 2016;99:1026–32.CrossRefPubMed
9.
Delgado JM, Ruppar TM. Health literacy in older Latinos with heart failure: a systematic review. J Cardiovasc Nurs. 2015.
10.
•• Clark AM, Wiens KS, Banner D, Kryworuchko J, Thirsk L, McLean L, et al. A systematic review of the main mechanisms of heart failure disease management interventions. Heart. 2016;102:707–11. Systematic review of qualitative and quantitative studies using realist synthesis including 33 studies (18 randomised controlled trials, three mixed methods studies, six pre-test post-test studies and six qualitative studies).CrossRefPubMed
11.
Dickson VV, Melkus GD, Katz S, Levine-Wong A, Dillworth J, Cleland CM, et al. Building skill in heart failure self-care among community dwelling older adults: results of a pilot study. Patient Educ Couns. 2014;96:188–96.CrossRefPubMed
12.
Zhang KM, Dindoff K, Arnold JMO, Lane J, Swartzman LC. What matters to patients with heart failure? The influence of non-health-related goals on patient adherence to self-care management. Patient Educ Couns. 2015;98:927–34.CrossRefPubMed
13.
Klompstra L, Jaarsma T, Strömberg A. Physical activity in patients with heart failure: barriers and motivations with special focus on sex differences. Patient Prefer Adherence. 2015;9:1603–10.CrossRefPubMedPubMedCentral
14.
Sethares KA, Flimlin HE, Elliott KM. Perceived benefits and barriers of heart failure self-care during and after hospitalization. Home Healthc Nurse. 2014;32:482–8.CrossRefPubMed
15.
•• Karimi M, Clark AM. How do patients’ values influence heart failure self-care decision-making?: A mixed-methods systematic review. Int J Nurs Stud. 2016;59:89–104. A mixed methods systematic review was conducted using a critical meta-narrative synthesis approach to synthesize qualitative and quantitative data from 54 studies were (30 qualitative, 8 mixed methods, and 16 quantitative; 6045 patients, 38 lay caregivers, and 96 health care professionals).CrossRefPubMed
16.
Spaling MA, Currie K, Strachan PH, Harkness K, Clark AM. Improving support for heart failure patients: a systematic review to understand patients’ perspectives on self-care. J Adv Nurs. 2015;71:2478–89.CrossRefPubMed
17.
Volpp KG, Asch DA. Make the healthy choice the easy choice: using behavioral economics to advance a culture of health. QJM. 2016.
18.
Loewenstein G, Asch DA, Volpp KG. Behavioral economics holds potential to deliver better results for patients, insurers, and employers. Health Aff. 2013;32:1244–50.CrossRef
19.
• Jaarsma T, Stromberg A, Ben Gal T, Cameron J, Driscoll A, Duengen HD, et al. Comparison of self-care behaviors of heart failure patients in 15 countries worldwide. Patient Educ Couns. 2013;92:114–20. Study on self-care including data from 15 countries with data on self-care from 5964 heart failure patients from the United States, Europe, Australasia and South America.CrossRefPubMed
20.
• Riegel B, Driscoll A, Suwanno J, Moser D, Lennie T, Chung M, et al. Heart failure self-care in developed and developing countries. J Card Fail. 2009;15:508–16. A total of 2082 adults from 2 developed (United States and Australia) and 2 developing countries (Thailand and Mexico) were studied in a descriptive, comparative study.CrossRefPubMedPubMedCentral
21.
Roberson MR, Kelley JH. Using Orem’s theory in transcultural settings: a critique. Nurs Forum. 1996;31:22–8.CrossRefPubMed
22.
23.
Srisuk N, Cameron J, Ski CF, Thompson DR. Trial of a family-based education program for heart failure patients in rural Thailand. BMC Cardiovasc Disord. 2014;14:173.CrossRefPubMedPubMedCentral
24.
Srisuk N, Cameron J, Ski CF, Thompson DR. Randomized controlled trial of family-based education for patients with heart failure and their carers. J Adv Nurs 2016:n/a-n/a.
25.
Kato NP, Kinugawa K, Sano M, Kogure A, Sakuragi F, Kobukata K, et al. How effective is an in-hospital heart failure self-care program in a Japanese setting? Lessons from a randomized controlled pilot study. Patient Prefer Adherence. 2016;10:171–81.CrossRefPubMedPubMedCentral
26.
Deek H, Noureddine S, Newton PJ, Inglis SC, MacDonald PS, Davidson PM. A family-focused intervention for heart failure self-care: conceptual underpinnings of a culturally appropriate intervention. J Adv Nurs. 2016;72:434–50.CrossRefPubMed
27.
Dickson VV, Knafl GJ, Riegel B. Predictors of medication nonadherence differ among black and white patients with heart failure. Res Nurs Health. 2015;38:289–300.CrossRefPubMedPubMedCentral
28.
Rong X, Peng Y, Yu HP, Li D. Cultural factors influencing dietary and fluid restriction behaviour: perceptions of older Chinese patients with heart failure. J Clin Nurs. 2016. doi: 10.​1111/​jocn.​13515.
29.
MacInnes J. Relationships between illness representations, treatment beliefs and the performance of self-care in heart failure: a cross-sectional survey. Eur J Cardiovasc Nurs. 2013;12:536–43.CrossRefPubMed
30.
Kamrani AA, Foroughan M, Taraghi Z, Yazdani J, Kaldi AR, Ghanei N, et al. Self care behaviors among elderly with chronic heart failure and related factors. Pak J Biol Sci. 2014;17:1161–9.CrossRefPubMed
31.
•• Kessing D, Denollet J, Widdershoven J, Kupper N. Psychological determinants of heart failure self-care: systematic review and meta-analysis. Psychosom Med. 2016;78:412–31. Systematic review and meta-analysis of 65 studies.CrossRefPubMed
32.
Bratzke-Bauer LC, Pozehl BJ, Paul SM, Johnson JK. Neuropsychological patterns differ by type of left ventricle dysfunction in heart failure. Arch Clin Neuropsychol. 2013;28:114–24.CrossRefPubMed
33.
Nordlund A, Berggren J, Holmström A, Fu M, Wallin A. Frequent mild cognitive deficits in several functional domains in elderly patients with heart failure without known cognitive disorders. J Card Fail. 2015;21:702–7.CrossRefPubMed
34.
Currie K, Rideout A, Lindsay G, Harkness K. The association between mild cognitive impairment and self-care in adults with chronic heart failure: A systematic review and narrative synthesis. J Cardiovasc Nurs. 2015;30:382–93.CrossRefPubMed
35.
Cannon JA, McMurray JJ, Quinn TJ. ‘Hearts and minds’: association, causation and implication of cognitive impairment in heart failure. Alzheimers Res Ther. 2015;7:22.CrossRefPubMedPubMedCentral
36.
Cameron J, Worrall-Carter L, Page K, Riegel B, Lo SK, Stewart S. Does cognitive impairment predict poor self-care in patients with chronic heart failure? Eur J Heart Fail. 2010;12:508–15.CrossRefPubMed
37.
Riley PL, Arslanian-Engoren C. Cognitive dysfunction and self-care decision making in chronic heart failure: A review of the literature. Eur J Cardiovasc Nurs. 2013;12:505–11.CrossRefPubMed
38.
Hjelm CM, Broström A, Riegel B, Årestedt K, Strömberg A. The association between cognitive function and self-care in patients with chronic heart failure. Heart Lung. 2015;44:113–9.CrossRefPubMed
39.
Dolansky MA, Hawkins MA, Schaefer JT, Gunstad J, Sattar A, Redle JD, et al. Cognitive function predicts risk for clinically significant weight gain in adults with heart failure. J Cardiovasc Nurs. 2016.
40.
Dolansky MA, Hawkins MAW, Schaefer JT, Sattar A, Gunstad J, Redle JD, et al. Association between poorer cognitive function and reduced objectively monitored medication adherence in patients with heart failure. Circ Heart Fail. 2016;9:e002475.CrossRefPubMed
41.
Pressler SJ, Titler M, Koelling TM, Riley PL, Jung M, Hoyland-Domenico L, et al. Nurse-enhanced computerized cognitive training increases serum brain-derived neurotropic factor levels and improves working memory in heart failure. J Card Fail. 2015;21:630–41.CrossRefPubMed
42.
Athilingam P, Edwards JD, Valdes EG, Ji M, Guglin M. Computerized auditory cognitive training to improve cognition and functional outcomes in patients with heart failure: results of a pilot study. Heart Lung. 2015;44:120–8.CrossRefPubMed
43.
Vellone E, Pancani L, Greco A, Steca P, Riegel B. Self-care confidence may be more important than cognition to influence self-care behaviors in adults with heart failure: testing a mediation model. Int J Nurs Stud. 2016;60:191–9.CrossRefPubMed
44.
Vellone E, D’Agostino F, Buck HG, et al. The key role of caregiver confidence in the caregiver’s contribution to self-care in adults with heart failure. Eur J Cardiovasc Nurs. 2015;14:372–81.CrossRefPubMed
45.
Lyons KS, Vellone E, Lee CS, et al. A dyadic approach to managing heart failure with confidence. J Cardiovasc Nurs. 2015;30(4 Suppl 1):S64–71.CrossRefPubMed
46.
•• Strachan PH, Currie K, Harkness K, Spaling M, Clark AM. Context matters in heart failure self-care: a qualitative systematic review. J Card Fail. 2014;20:448e455. A systematic, comprehensive and detailed search of 11 databases was conducted until March, 2012 for papers published 1995–2012: 37 studies were included (1343 patients, 75 caregivers, 63 health care professionals).CrossRef
47.
Luttik ML, Jaarsma T, Strömberg A. Changing needs of heart failure patients and their families during the illness trajectory: a challenge for health care. Eur J Cardiovasc Nurs. 2016;15:298–300.CrossRefPubMed
48.
Graven LJ, Grant JS, Vance DE, Pryor ER, Grubbs L, Karioth S. Predicting depressive symptoms and self-care in patients with heart failure. Am J Health Behav. 2015;39:77–87.CrossRefPubMed
49.
Buck HG, Mogle J, Riegel B, McMillan S, Bakitas M. Exploring the relationship of patient and informal caregiver characteristics with heart failure self-care using the actor-partner interdependence model: implications for outpatient palliative care. J Palliat Med. 2015;18:1026–32.CrossRefPubMed
50.
Näsström L, Luttik ML, Idvall E, Strömberg A. Exploring partners’ perspectives on participation in heart failure home-care. A mixed method design. J Adv Nurs. 2016.
51.
Liljeroos M, Ågren S, Jaarsma T, Strömberg A. Perceived caring needs in patient-partner dyads affected by heart failure: a qualitative study. J Clin Nurs. 2014;23:2928–38.CrossRefPubMed
52.
Do V, Young L, Barnason S, Tran H. Relationships between activation level, knowledge, self-efficacy, and self-management behavior in heart failure patients discharged from rural hospitals. F1000Res. 2015;4:150.PubMedPubMedCentral
53.
Caldwell MA, Peters KJ, Dracup KA. A simplified education program improves knowledge, self-care behavior, and disease severity in heart failure patients in rural settings. Am Heart J. 2005;150(5):983 e7–e12.CrossRef
Metadata
Title
Factors Related to Self-Care in Heart Failure Patients According to the Middle-Range Theory of Self-Care of Chronic Illness: a Literature Update
Authors
Tiny Jaarsma
Jan Cameron
Barbara Riegel
Anna Stromberg
Publication date
01-04-2017
Publisher
Springer US
Published in
Current Heart Failure Reports / Issue 2/2017
Print ISSN: 1546-9530
Electronic ISSN: 1546-9549
DOI
https://doi.org/10.1007/s11897-017-0324-1

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