The Situation-Specific Theory of Heart Failure Self-care

Abstract

Many studies of heart failure (HF) self-care have been conducted since the last update of the situation-specific theory of HF self-care. Objective The aim of this study was to describe the manner in which characteristics of the problem, person, and environment interact to influence decisions about self-care made by adults with chronic HF. Methods This study is a theoretical update. Literature on the influence of the problem, person, and environment on HF self-care is summarized. Results Consistent with naturalistic decision making, the interaction of the problem, person, and environment creates a situation in which a self-care decision is needed. Problem factors influencing decisions about HF self-care include specific conditions such as cognitive impairment, diabetes mellitus, sleep disorders, depression, and symptoms. Comorbid conditions make HF self-care difficult for a variety of reasons. Person factors influencing HF self-care include age, knowledge, skill, health literacy, attitudes, perceived control, values, social norms, cultural beliefs, habits, motivation, activation, self-efficacy, and coping. Environmental factors include weather, crime, violence, access to the Internet, the built environment, social support, and public policy. Conclusions A robust body of knowledge has accumulated on the person-related factors influencing HF self-care. More research on the contribution of problem-related factors to HF self-care is needed because very few people have only HF and no other chronic conditions. The research on environment-related factors is particularly sparse. Seven new propositions are included in this update. We strongly encourage investigators to consider the interactions of problem, person, and environmental factors affecting self-care decisions in future studies.

The Relationships Among Health Literacy, Patient Activation, and Self-Care Behaviors in Adults With Heart Failure: A Cross Sectional Study

“…To improve HF self-care, it is imperative to identify modifiable factors that promote adherence. According to Riegel et al (2022), HF self-care is dependent on individuals' decisions to engage in self-care behaviors. It is heavily influenced by person-related factors and individual characteristics.…”

Remote motivational interviewing to improve patient self‐care and caregiver contribution to self‐care in heart failure (REMOTIVATE‐HF): Rationale, design, and methodology for a multicentre randomized controlled trial

“…HF patient self‐care is defined as those behaviors performed to maintain disease stability (self‐care maintenance), monitor and perceive related symptoms (self‐care monitoring and symptom perception), and respond to signs and symptoms of an HF exacerbation (self‐care management (Riegel et al, 2022). Caregiver contributions to HF self‐care is defined as “the process of recommending to (or substituting for) the patient to perform those behaviors that help (1) maintain the stability of HF conditions (caregiver contribution to self‐care maintenance), (2) facilitate HF symptom monitoring and perception (caregiver contribution to symptom monitoring and perception), and (3) the management of signs and symptoms of an HF exacerbation when they occur (caregiver contribution to self‐care management” (p 167) (Vellone et al, 2019).…”

“…The theoretical framework that guided the design of the present trial is the situation‐specific theory of HF self‐care (Riegel et al, 2022), which postulates that self‐care behaviors are influenced by person, problem, and environmental factors. Self‐care self‐efficacy is a critical driver in the theory because it can mediate the relationship between such factors and self‐care.…”

“…HF patient self-care is defined as those behaviors performed to maintain disease stability (self-care maintenance), monitor and perceive related symptoms (self-care monitoring and symptom perception), and respond to signs and symptoms of an HF exacerbation (self-care management (Riegel et al, 2022). Caregiver contributions to HF self-care is defined as "the process of recommending to (or substituting for) the patient to perform those behaviors that help (1) maintain the stability of HF conditions (caregiver contribution to self-care maintenance),…”

The Influence of Informal Caregivers' Preparedness on Psychological Symptoms and Quality of Life Among Patients With Heart Failure And Insufficient Self-care

“…Although family caregivers are neither professionally engaged in caring for other people nor paid for their time, they play a key role in delivering care and support services to patients having a chronic illness or disability 10 . Riegel et al 4 published and updated the situation-specific theory of caregiver contribution to self-care of HF (CC-SCHF), which includes 3 dimensions: caregiver contribution to self-care maintenance, caregiver contribution to self-care management, and caregiver contribution to self-care confidence.…”