Title

A Qualitative Meta-Analysis of Heart Failure Self-Care Practices Among Individuals With Multiple Comorbid Conditions

Document Type

Article

Publication Date

5-2011

Keywords

self-care, heart failure, comorbidity

Digital Object Identifier (DOI)

http://dx.doi.org/10.1016/j.cardfail.2010.11.011

Abstract

Background: Most heart failure (HF) patients have other comorbid conditions. HF self-care requires medication and diet adherence, daily weight monitoring, and a thoughtful response to symptoms when they occur. Self-care is complicated when other chronic conditions have additional self-care requirements. The purpose of this study is to explore how comorbidity influences HF self-care. Methods: Using qualitative descriptive meta-analysis techniques, transcripts from 3 mixed methods studies (n = 99) were reexamined to yield themes about perceptions about HF and self-care and to explore the influence on HF self-care. The Charlson Comorbidity Index identified comorbid conditions.

Results: The sample was 74% Caucasian, 66% male (mean age of 59.6 years ± 15 years). Fifty-three percent of the sample was New York Heart Association Class III. All had at least 1 other chronic condition. Narrative accounts revealed that adherence to diet, symptom monitoring, and differentiating symptoms from multiple conditions were the most challenging self-care skills. Emerging themes included 1) attitudes drive self-care prioritization and 2) fragmented self-care instruction leads to poor self-care integration and self-care skill deficits.

Conclusions: Individuals with multiple chronic conditions are vulnerable to poor self-care. Research testing coaching interventions that integrate self-care requirements and focus on developing skill in self-care across multiple chronic conditions is needed.

Was this content written or created while at USF?

No

Citation / Publisher Attribution

Journal of Cardiac Failure, v. 17, issue 5, p. 413-419