The lived experience of adherence for patients with heart failure

J Cardiopulm Rehabil. May-Jun 2005;25(3):158-63. doi: 10.1097/00008483-200505000-00006.


Background: Nonadherence is the primary cause of hospital readmission for patients with heart failure. While some demographic and social variables are associated with adherence, the identification of these variables does not address the complex problem of adherence. This study explored the lived experience of patients with heart failure as they attempt to adhere to a prescribed regimen of care.

Methods: Fourteen patients attending an outpatient heart failure clinic after hospital readmission for exacerbation of heart failure symptoms were interviewed. Transcription of the interviews provided data for phenomenological analysis and interpretation.

Results: Data analysis indicated that within the experience of attempting to adhere to prescribed care regimens, participants' initial acceptance of their diagnosis resulted in a changed self-image. Behaviors appropriate to the new self-image were integrated into the former lifestyle by means of planning and setting routine. Identified themes that influence adherence to the new behaviors included personal beliefs and values, support from significant others and healthcare professionals, unusual circumstances, and temptation overcoming motivation.

Conclusions: Adherence is primary to the effectiveness of any health regimen. Assessment of personal and circumstantial elements that affect adherence can be useful in developing more effective individualized treatment plans for this population. A closer look at discrete events of nonadherent decision making may indicate effective ways to promote adherence.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Health Behavior
  • Health Knowledge, Attitudes, Practice*
  • Heart Failure / physiopathology
  • Heart Failure / psychology
  • Heart Failure / therapy*
  • Humans
  • Interpersonal Relations
  • Interviews as Topic
  • Life Change Events*
  • Male
  • Middle Aged
  • Patient Compliance / psychology*
  • Patient Readmission
  • Qualitative Research
  • Self Care*
  • Self Concept
  • Treatment Refusal