Objective: Identify self-care actions of patients with heart failure in two settings: the emergency and outpatient care units, and to identify the main precipitating factors of heart decompensation. Methods: Cross-sectional study including 120 patients with heart failure in two settings, emergency and outpatient care units. Three validated instruments were used. Results: There was no statistically significant difference between the self-care groups, with low scores on weight control, vaccination and communication. Most of the study population was elderly, retired, with Chagas disease, and patients from the emergency care unit had the worst levels of urea, creatinine and hemoglobin. Conclusion: The patients practice self-care when they perceive aggravation in their clinical conditions and communication, weight control and vaccination, with no difference between the groups. Heart failure in emergency room patients may be associated with sociodemographic factors and characteristics of severity, including hemodynamic profile related to prolonged hospitalization and high mortality. ResumoObjetivo: Identificar as ações de autocuidado em portadores de insuficiência cardíaca em dois cenários: no pronto socorro e no ambulatório e identificar os principais fatores precipitantes de descompensação. Métodos: Estudo transversal no qual foram incluídos 120 portadores de insuficiência cardíaca em dois cenários: ambulatório e pronto socorro. Foram utilizados três instrumentos validados. Resultados: Não houve diferença estatisticamente significativa do autocuidado entre os grupos, com baixa pontuação sobre o controle de peso, vacinação e comunicação. A maioria da população de estudo era de idosos, aposentados, com doença de Chagas e, no grupo do pronto socorro tivemos os piores níveis de ureia, creatinina e hemoglobina. Conclusão: Os pacientes praticam o autocuidado na percepção de piora clínica e comunicação; controle de peso e vacinação, sem diferença entre os grupos. A descompensação nos pacientes do pronto socorro pode estar associada a fatores sociodemográficos e características de gravidade, incluindo o perfil hemodinâmico, relacionado à prolongada internação e alta letalidade.
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