Patient and caregivers self-care needs in relation to heart failure: developing guidance for patient care in the community

Abstract

This report presents the outcomes of a project which aimed to improve community nursing practice in relation to promoting and supporting effective self-care for patients who live with chronic heart failure in the community. The project team conducted a robust review and meta-synthesis of qualitative research evidence to ‘understand heart failure self-care in terms of patients own self-care management techniques and how elements of context affect heart failure self-care, identifying the causal barriers and facilitators of self-care actions.’ The evidence indicates that formal knowledge does not necessarily lead to better self-care, as patients often report knowing ‘what’ they ought to do, yet have difficulty knowing ‘how’ to integrate this knowledge in their daily lives. In addition, research points to persistent misunderstandings or misconceptions held by patients. Similarly, individuals’ attitudes, beliefs and personal values also influence their interpretation of self-care advice. Thus, self-care is not simply a matter of adequate knowledge; it is a complex social process, enacted in a variety of contexts, and influenced by a wide range of factors. Health professional support for self-care requires an appreciation of the individual, the complexity of their circumstances and the provision of tailored practical information and advice; simply imparting formal knowledge or instructions may not result in the desired outcome. The outcomes of that synthesis were used to create guidance which could be incorporated into educational provision for professionals working in the field of heart failure. <br/