Factors Influencing Self-Care Among Patients With Heart Failure Based on the Situation-Specific Theory: A Cross-Sectional Study

Abstract

Aim: To investigate the sociodemographic and clinical factors of patients with heart failure and determine the significant predictors of self-care in this population based on the situation-specific theory of heart failure self-care. Background: Heart failure is a rapidly increasing global health concern, necessitating the development of effective self-care strategies for better management. Design and Methods: This cross-sectional study included 134 patients diagnosed with heart failure at a university-affiliated hospital in South Korea. Data were collected between June and September 2023. Self-care was measured using the Self-Care of Heart Failure Index version 7.2. Symptom experience, knowledge, health literacy, self-efficacy, and social support were measured as independent variables. Data were analysed using multiple regression analyses with SPSS 25.0. Results: The factors influencing self-care were age, employment status, symptom experience, self-efficacy and social support for ‘self-care maintenance’, health literacy and self-efficacy for ‘symptom perception’, and age, religion, health literacy, self-efficacy and social support for ‘self-care management’. The explanatory powers of the final models for ‘self-care maintenance’, ‘symptom perception’ and ‘self-care management’ were 39.4%, 31.0% and 44.1%, respectively. Conclusion: Health literacy, self-efficacy, symptom experience and social support were key predictors of self-care among patients with heart failure. Nurses should assess these factors and provide tailored, literacy-sensitive education and support to strengthen patients' confidence and resources. These findings may guide practice guidelines and development of theory-based nursing interventions to improve self-care.