title: Barriers and facilitators to self-care in chronic heart failure: a meta-synthesis of qualitative studies.
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.
authors: Victor Coppleson Building - D02, Menzies Center for Health Policy, Medical School, The University of Sydney, Sydney, Australia ; School of Health, Kermansha University of Medical Sciences, Kermanshah, Iran.
authors: Soraya
authors: S
authors: Siabani
authors: Stephen R
authors: SR
authors: Leeder
authors: Patricia M
authors: PM
authors: Davidson
keywords: CHF; Compliance; Congestive heart failure; Qualitative review; Self-care determinants; Self-management; Treatment adherence
references: Appl Nurs Res. 2002 Nov;15(4):200-8
references: 12444578
references: J Cardiovasc Nurs. 2010 Jul-Aug;25(4):273-83
references: 20539162
references: Worldviews Evid Based Nurs. 2008;5(3):160-2
references: 19076914
references: Heart Lung. 2004 Jul-Aug;33(4):249-60
references: 15252415
references: Nurs Res. 2003 Jul-Aug;52(4):226-33
references: 12867779
references: Cardiol Res Pract. 2011 Mar 06;2011:918973
references: 21403845
references: Patient Educ Couns. 2010 Mar;78(3):297-315
references: 20202778
references: Scand J Gastroenterol. 2011 Jul;46(7-8):823-30
references: 21561228
references: Contemp Nurse. 2007 May-Jun;25(1-2):50-61
references: 17622989
references: J Cardiovasc Nurs. 2006 May-Jun;21(3):232-41
references: 16699364
references: J Adv Nurs. 2006 Aug;55(4):457-64
references: 16866841
references: Eur J Heart Fail. 2011 Apr;13(4):450-9
references: 21193439
references: Can J Cardiovasc Nurs. 2006;16(1):13-9
references: 16615260
references: Eur J Cardiovasc Nurs. 2006 Mar;5(1):45-53
references: 16014340
references: Arch Intern Med. 2010 Feb 22;170(4):340-6
references: 20177036
references: Eur J Heart Fail. 2010 Apr;12(4):389-96
references: 20172940
references: J Cardiovasc Nurs. 2013 Mar-Apr;28(2):111-8
references: 22343210
references: J Health Serv Res Policy. 2005 Jan;10(1):45-53
references: 15667704
references: Heart Fail Rev. 2002 Jan;7(1):9-16
references: 11790919
references: Res Nurs Health. 1997 Aug;20(4):365-71
references: 9256882
references: Int J Evid Based Healthc. 2009 Sep;7(3):159-68
references: 21631856
references: Eur J Heart Fail. 2009 Jun;11(6):617-21
references: 19414477
references: Z Kardiol. 2003 Dec;92(12):985-93
references: 14663608
references: J Am Acad Nurse Pract. 2008 Apr;20(4):217-24
references: 18387019
references: Med J Aust. 2008 Feb 18;188(4):243-6
references: 18279135
references: Psychol Psychother. 2010 Jun;83(Pt 2):207-21
references: 19883526
references: BMC Health Serv Res. 2009 Oct 09;9:182
references: 19818128
references: Am J Med Qual. 2008 Sep-Oct;23(5):389-95
references: 18820144
references: J Cardiovasc Nurs. 2008 May-Jun;23(3):285-92
references: 18437071
references: Nurs Res. 2009 Jul-Aug;58(4):283-93
references: 19609180
references: Fam Pract. 2006 Dec;23(6):624-30
references: 16837480
references: Contemp Clin Trials. 2006 Jun;27(3):274-86
references: 16427365
references: Eur J Heart Fail. 2003 Jun;5(3):371-80
references: 12798837
references: Circulation. 2011 Mar 1;123(8):933-44
references: 21262990
references: Circulation. 2013 Jan 1;127(1):e6-e245
references: 23239837
references: Patient Educ Couns. 2002 Apr;46(4):287-95
references: 11932128
references: Ann Behav Med. 2008 Feb;35(1):70-9
references: 18347906
references: BMJ. 2000 Sep 9;321(7261):605-7
references: 10977838
references: Eur J Cardiovasc Nurs. 2008 Sep;7(3):171-81
references: 18178132
references: Eur J Cardiovasc Nurs. 2007 Sep;6(3):192-9
references: 17141572
references: Home Healthc Nurse. 2004 Feb;22(2):109-15
references: 15076084
references: Curr Cardiol Rep. 2012 Jun;14(3):265-75
references: 22437374
references: Int J Nurs Stud. 2010 Jul;47(7):888-95
references: 20079902
references: Qual Health Res. 2004 Dec;14(10):1342-65
references: 15538004
references: Am Heart J. 2008 Sep;156(3):452-60
references: 18760125
references: BMJ. 2008 Aug 07;337:a1035
references: 18687726
references: J Gerontol Nurs. 1992 Oct;18(10):27-32
references: 1479155
references: West J Med. 2000 Feb;172(2):124-8
references: 10693376
references: J Psychosom Res. 1999 Dec;47(6):555-67
references: 10661603
references: Eur J Heart Fail. 2011 Feb;13(2):115-26
references: 21148593
references: Soc Sci Med. 2004 Feb;58(3):631-43
references: 14652059
references: BMC Med Res Methodol. 2009 Aug 11;9:59
references: 19671152
references: J Nurs Scholarsh. 2010 Mar;42(1):92-100
references: 20487191
references: Nat Clin Pract Gastroenterol Hepatol. 2009 Feb;6(2):82-91
references: 19153565
references: Eur J Heart Fail. 2001 Jun;3(3):283-91
references: 11377998
references: Rev Esp Cardiol. 2008 Oct;61(10):1041-9
references: 18817680
references: Nurs Res. 2007 Jul-Aug;56(4):235-43
references: 17625462
references: Patient Educ Couns. 2001 Mar;42(3):279-87
references: 11164327
references: Patient Educ Couns. 2008 Feb;70(2):281-91
references: 18068939
references: J Cardiovasc Nurs. 2009 Nov-Dec;24(6):485-97
references: 19786884
references: J Adv Nurs. 1997 Mar;25(3):579-86
references: 9080286
references: Fam Pract. 2001 Apr;18(2):117-22
references: 11264259
references: Heart Lung. 2009 May-Jun;38(3):253-61
references: 19486796
references: Heart Lung. 2002 Mar-Apr;31(2):102-12
references: 11910385
references: Heart Lung. 2008 Jul-Aug;37(4):257-65
references: 18620101
references: J Cardiopulm Rehabil. 2005 May-Jun;25(3):158-63
references: 15931019
references: Eur J Heart Fail. 2001 Dec;3(6):723-30
references: 11738225
references: J Cardiovasc Nurs. 2009 Jul-Aug;24(4):308-15
references: 19465865
references: Arch Intern Med. 2002 Mar 11;162(5):509-16
references: 11871918
references: BMC Health Serv Res. 2010 Mar 24;10:77
references: 20331904