European Journal of Heart Failure Advance Access originally published online on May 4, 2009
European Journal of Heart Failure 2009 11(6):617-621; doi:10.1093/eurjhf/hfp058
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Patient and informal caregivers’ knowledge of heart failure: necessary but insufficient for effective self-care
1 Faculty of Nursing, Level 3 CSB, University of Alberta, Edmonton, AB., Canada T6R 2R6
2 Department of Medicine, University of Alberta, Edmonton, AB., Canada T6R 2R6
3 Faculty of Arts and Alberta Centre on Aging, University of Alberta, Edmonton, AB., Canada T6R 2R6
* Corresponding author. Tel: +1 780 492 8347, Fax: +1 780 492 2551, Email: alex.clark{at}ualberta.ca
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Abstract |
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Aims: Self-care of heart failure (HF) is a process that is important, complex, and challenging. Little is understood of the contextual factors influencing self-care. We aimed to examine the individual and contextual factors perceived by patients and their informal caregivers’ to influence their willingness and capacity to undertake effective HF self-care.
Methods and results: This was a qualitative study using semi-structured interviews with 42 patients with HF (NYHA Class II and III, mean age: 76 years, 64% males) and 30 nominated caregivers (63% spouses). All patients experienced severe and intrusive HF symptoms; a large proportion of patients practiced some of the range of recommended self-care activities. However, links between knowledge of HF and self-care were weak and long delays in seeking professional care were frequent. Factors consistently reported to influence self-care were faith in health professionals, beliefs about the local health system, and values linked to work associated with place, history, and culture.
Conclusion: Knowledge of HF and its management is a necessary though not sufficient determinant of HF self-care. Individual and contextual factors influence willingness and capacity to undertake effective HF self-care.
Key Words: Disease management • Support • Education • Health services • Context • Compliance
Received November 24, 2008; Revised March 11, 2009; Accepted March 18, 2009