An integrative review of interventions promoting self-care of patients with heart failure

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Aim and objective. To examine the interventions used to improve self-care of heart failure patients. The specific objectives were to examine the efficacy of interventions to improve heart failure self-care (self-maintenance and self-management behaviours) and patient-related factors such as knowledge about heart failure, self-efficacy for heart failure self-care (confidence) and beliefs regarding heart failure self-care. Background. Despite the significant advances in the treatment and management of heart failure, there continues to be poor patient outcomes associated with this clinical syndrome. Design. An integrative review. Method. A search of MEDLINE, PsychINFO, Cochrane data base of clinical trials and the cumulative index of nursing and allied health literature (CINAHL) databases was conducted using 14 search terms for a period from 2000-2010. Hand searching of reference lists and author lists was also conducted. Nineteen eligible self-care intervention studies were included in this review. Results. Cognitive-behavioural intervention mechanisms were most frequently used to improve patient's heart failure self-care. In the majority of the studies, the interventions demonstrated efficacy by improving heart failure patients' self-care maintenance and management behaviours. Intervention group subjects, in the majority of studies, had significantly higher levels of knowledge pertaining to heart failure and heart failure related self-care. Relevance to clinical practice. Based on these findings, there are improved patient outcomes when standard patient education for heart failure is augmented using cognitive-behavioural strategies that include additional evidence-based education and counselling.

Original languageEnglish (US)
Pages (from-to)448-475
Number of pages28
JournalJournal of Clinical Nursing
Issue number3-4
StatePublished - Feb 2012


  • Heart failure
  • Self-care
  • Self-management

ASJC Scopus subject areas

  • General Nursing


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