How do Japanese Patients with Chronic Heart Failure View Their Disease, Self-care, and Support?

Abstract

Introduction: Chronic heart failure (HF) is a progressive disease with increasing prevalence in Japan. Adherence to lifestyle modifications is important to prevent disease progression and to improve outcomes. An accumulation of insufficient self-care behaviors is an independent risk factor of hospitalization for HF and/or cardiac death; however, there is a lack of self-care awareness in patients with chronic HF. This study aims to increase the understanding of self-care behavior of people living with chronic HF in Japan. Methods: This non-interventional, cross-sectional study used an explanatory sequential design in mixed methods research with a quantitative and consecutive qualitative phase. In the quantitative research phase, an anonymous online survey questionnaire was distributed to 262 people and completed by 162 participants. In the qualitative phase, 15 participants who had completed the quantitative phase were selected using stratified random sampling from the survey participants and took part in a semi-structured interview. Endpoints included participant demographics and HF characteristics, physical and emotional burdens associated with HF, knowledge of disease, self-care, and treatment support in daily life. Results: In the quantitative study, 61.5% of participants were male, and 68.9% were ≥ 60 years old. In the qualitative study, 80.0% were male and 46.7% were ≥ 70 years old. Participants experienced physical and emotional burden due to their HF symptoms with > 60% finding brisk walking, and > 40% finding going up stairs to the second floor, burdensome or very burdensome, and approximately 70% experiencing some emotional burden. In general, participants trusted their physicians’ instructions around self-care and had a high level of self-care adherence. Participants would like more information regarding HF treatment (68.0%), diet and nutrition (57.3%), and daily lifestyle tips to reduce HF burden (57.3%). Conclusion: This study highlights the importance of patient education, and the need for multidisciplinary support for patients with chronic HF. Trial Registration: UMIN000047055, March 1, 2022 and UMIN000049065, September 29, 2022.