Table 3 Barriers and facilitators to self-care in chronic heart failure
Author / Year/ Country / Ref | Barriers /and the behaviours they affected | Facilitators/ and the behaviors they affected |
|---|---|---|
Martensson et al. (1997) Sweden | - Physical limitation, feeling lack of energy / physical activity | - Awareness of threat / physical activity |
- Hopelessness / decision making and motivation for management symptom | - Environmental support/ self-confidence | |
- Short term memory loss and confusion / taking medicinel | ||
(Rogers et al. 2000) United Kingdom | - Misconception about CHF / medical and regimen adherence | |
- Acceptance / decision making | ||
- Lack of facility / access to medical care | ||
- Avoidance, acceptance and denial / to obtain new information for caring themselves, and participate in decision making | ||
Buetow et al. (2001) New Zealand | - Multiple medicine, side effects of medicine / adherence to treatment | - Coping strategies of disavowal / taking medication and following prescriptions |
Riegel & Carlson (2002) USA | - Lack of knowledge / adherence to regimen and exercise | - Supportive strategies; emotionally and tangibly / motivation, hope, adaptation with CHF |
- Atypical symptom and complexity of symptom / failing in following recommended diet | ||
- Negative emotion and no environment support/ motivation | ||
- Comorbidity / complexity of self-care and difficulty in symptom recognition | ||
- Inadequate information (about CHF, its symptoms and their management)/ symptom recognition and definition of source of exacerbation symptom + symptom monitoring + receiving medical care | ||
Horowitz et al. (2004) USA | ||
Scotto (2005) USA | - Conflict between values of patients and nurses / not accepting new information and recommendation | - Acceptance and support from health care professional / adaptation to new life leads to adherent to appropriate self-care behaviors ( physical activity and adherence to prescribed instructions) |
Eldh et al. (2006) Sweden | - Insufficient knowledge of educators and nurses / patients’ knowledge and skill for self-care | - Respect for patients / Increasing their knowledge and Participate in decision making |
Riegel et al. (2006) USA | - Lack of knowledge / specially regarding diet and salt restriction | - Sympathy, reflective listening, acknowledging cultural values / engage patients to enhance their knowledge, skill and motivation to fallow self-care rules |
- Information / building skills of self-care in patients -Stimulating supporting resources / collaboration and participate in care programs | ||
Rucker-Whitaker et al. (2006) USA | - Denial and anxiety / taking medicine | - Social activity and mutual support / motivation |
- Education especially with patients’ own language / adherence to regimen | ||
Dissatisfaction with received care / failed perceived benefit of self-care action such salt limitation | ||
Schnell et al. (2006) Canada | Hopelessness / motivation for physical activity and dietary regimen | - Social support, satisfaction with health system delivery/Positive outlook, perform self-care behavior |
- Simplicity of self-care/ daily weighing and symptom monitoring, | ||
- Understanding reason for self-care / perceived health care roles, perceived benefit associated with physical activity | ||
Falk et al. (2007) Sweden | Cultural issues, health seeking behaviours / adherence to regimen | - Trust family and formal care givers / following instructions |
- Social activity/ physical activity | ||
- perceiving the risk of withdrawing medicine / adherence to medicine and regimen | ||
- Facility ( Care availability) / care - seeking | ||
Davidson et al. (2007) Australia | - Cognition problems due to CHF symptom / weighting, regiment, taking water pill | |
Riegel et al. (2007) USA | - Depression / motivation for self-care | |
- Poor family functioning / self-care maintenance and management | ||
- Denial of illness/ adherence to regimen and treatment | ||
Kaholokula et al. (2008) USA | - Hopelessness/ decision making | |
- Lack of family knowledge/ misconception about treatment preference | ||
- Financial -burden / adherence to regimen | ||
- Lack of trust physicians / medical using herbal medicine | ||
- Lack of information about CHF symptom / symptom recognition and help-seeking | ||
Rodriguez et al. (2008) USA | - Comorbidity / symptom recognition (confusion about cause of symptoms ) | |
- Lack of knowledge / sodium restriction and decision making | ||
Sheahan & Fields (2008) USA | - Loneliness/ motivation to care | - Living with family / motivation for adherence to regime |
- Cultures / dietary behaviours | ||
- Lack of experience / medical adherence and symptom recognition | ||
Dickson et al. (2008) USA | - Side effect of medicine and interfere in work and normal life / medical adherence | - Long time experiences of HF / self-management and symptom monitoring |
Traditional education & insufficient skill in educators / developingself- maintenance (Diet, diuretic titration and exercise , low salt diet) | ||
Dickson & Riegel (2009) USA | - Complexity of self-care rules and no agreement between doctors and patients about this difficulty, hopelessness / fitting prescribed regimen into daily life all aspects of self-care were affected) | |
Granger et al. (2009) USA | - Side effects of medicine interfering with social activities / medical adherence | |
Clark et al. (2009) USA | - HF symptoms/ symptom recognition | |
- Lack of knowledge / self-management e.g. help-seeking and | ||
- Lack of confidence / self-management | ||
- Personal values linked to culture/ help-seeking | ||
- Female, depression/ self-care confidence, decision making and interpreting symptoms | ||
Riegel et al. (2010a) USA | - Poor family support/ symptom –management | - Male/ self-care confidence and symptom recognition |
- Family support , hopefulness/ symptom management | ||
- Complexity medicine / adherence to medicine | ||
Ming et al. (2011) Malaysia | - Limited communication of doctors / adherence to medication | Family support/ self-care confidence and adherence to treatment |
- Difficulty in remembering/ adherence to medication and regimen | ||
- Cultural issues / adherence to diet (having favorite food) | ||
Dickson et al. (2012/ published online) USA | - Knowledge /symptom monitoring and management (e.g. attributing CHF to stress) | - Social support / adherence to regimen and self- confidence |
- Financial support and access to facilities / adherence to medication, | ||
- Spirituality / motivate to care for themselves | ||
- Some cultural belief leading to strong familial support / engaging in self-care maintenance and self-care management, e.g. preparing unsalted food by family. |