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Abstract
Chronic heart failure (CHF) is a costly condition that places large demands on self-care. Failure to adhere with self-care recommendations is common and associated with frequent hospitalization. Understanding the factors that enable or inhibit self-care is essential in developing effective health care interventions. This qualitative review was conducted to address the research question, "What are the barriers and facilitators to self-care among patients with CHF?” Electronic databases including Medline, EMBASE, CINAHL, Web of Science, Scopus and Google scholar were searched. Articles were included if they were peer reviewed (1995 to 2012), in English language and investigated at least one contextual or individual factor impacting on self-care in CHF patients > 18years. The criteria defined by Kuper et al. including clarity and appropriateness of sampling, data collection and data analysis were used to appraise the quality of articles. Twenty-three articles met the inclusion criteria. Factors impacting on self-care were included factors related to symptoms of CHF and the self-care process; factors related to personal characteristics; and factors related to environment and self-care system. Important factors such as socioeconomic situation and education level have not been explored extensively and there were minimal data on the influence of age, gender, self-confidence and duration of disease. Although there is an emerging literature, further research is required to address the barriers and facilitators to self-care in patients with CHF in order to provide an appropriate guide for intervention strategies to improve self-care in CHF.
Highlights
Chronic heart failure (CHF) is a chronic progressive condition where the heart fails to meet the body’s metabolic demands
The prevalence of CHF has been reported as 0.4% to 2% in the general population and between 2.3% to over 16% among those aged >75years (Go et al 2013; AIHW 2011; Heidenreich et al 2011; Anguita Sanchez et al 2008; Masoudi et al 2002)
Time since diagnosis of CHF in eight studies was a minimum of six months (Falk et al 2007; Schnell et al 2006; Clark et al 2009; Ming et al 2011; Dickson et al 2012; Riegel et al 2010b), while other investigators included cases with a diagnosis duration of one month or more
Summary
Chronic heart failure (CHF) is a chronic progressive condition where the heart fails to meet the body’s metabolic demands. There is no comprehensive study which clarifies these factors For this purpose, reviewing qualitative studies is important in understanding patients’ experiences (Dixon-Woods et al 2005; Thorne et al 2004; Barnett-Page & Thomas 2009), health seeking behaviours (Murray 1998) and providing a clear insight into barriers and facilitators through uncovering beliefs and motivations of individuals (Dixon-Woods et al 2005; Kent & Fineout-Overholt 2008). The aim of this meta-synthesis review (Sandelowski & Barroso 2003) was to review studies that identify barriers and facilitators to self-care in patients with CHF
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