Impact of nursing based on Orem's self-care theory on self-care behaviours in older patients with heart failure: A randomised controlled trial

Abstract

Objective: This study aimed to evaluate the impact of Orem's self-care theory on self-care behaviours in older patients with chronic heart failure. Methods: A prospective randomised controlled trial that involved 104 older patients with heart failure who were admitted to the cardiology department of our hospital between November 2021 and April 2023. Participants were randomly assigned to either the control group or the study group. The study group received comprehensive nursing based on Orem's self-care deficit theory (OSCD), while the control group received standard nursing care. The two groups' self-care ability, medication adherence and mental health were compared. Results: After the intervention, the study group demonstrated significantly better self-care ability and medication adherence than the control group. Additionally, the improvement in the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores in the study group was significantly greater than in the control group. The study group also experienced fewer readmissions within 1 year than the control group. Conclusions: Implementing comprehensive nursing based on Orem's self-care theory in patients with chronic heart failure can significantly enhance self-care ability, improve medication adherence, enhance mental health and reduce readmission rates. Integrating Orem's self-care theory into routine heart failure management encourages a more holistic and empowering approach to care. It supports patient independence, strengthens nurse–patient engagement and may help health-care systems reduce readmission-related costs. This model is particularly valuable in managing chronic illnesses among older adults, where self-efficacy and adherence are often compromised.