Patient and informal caregivers' knowledge of heart failure: necessary but insufficient for effective self-care.
OBJECTIVE
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.


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.


CONCLUSIONS
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.
Faculty of Nursing, Level 3 CSB, University of Alberta, Edmonton, AB, Canada T6R 2R6. alex.clark@ualberta.ca
Alexander M
AM
Clark
C Nicole
CN
Freydberg
Finlay A
FA
McAlister
Ross T
RT
Tsuyuki
Paul W
PW
Armstrong
Laurel A
LA
Strain
D000368:Aged; D000416:Alberta; D017028:Caregivers / Q000592:standards*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D012648:Self Care / Q000379:methods* / Q000592:standards; D011795:Surveys and Questionnaires