title: An integrative review of interventions promoting self-care of patients with heart failure.
abstract: 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.
  
  
  METHODS
  An integrative review.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Nebraska Medical Center, College of Nursing-Lincoln Division, Lincoln, NE, USA. sbarnaso@unmc.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Barnason
authors.forename: Lani
authors.initials: L
authors.lastname: Zimmerman
authors.forename: Lufei
authors.initials: L
authors.lastname: Young
mesh_terms: D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D012648:Self Care