An integrative review of interventions promoting self‐care of patients with heart failure

Aim and 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. Design.  An integrative review. Method.  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. Relevance to clinical practice.  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.