Barriers to effective self-management in cardiac patients: the patient's experience

Patient Educ Couns. 2010 Apr;79(1):69-76. doi: 10.1016/j.pec.2009.08.003. Epub 2009 Sep 11.


Objective: This paper identifies common obstacles impeding effective self-management among patients with heart disease and explores how for disadvantaged patients access barriers interfere with typical management challenges to undermine patients' efforts to care for their illnesses.

Methods: We convened 33 focus group discussions with heart patients in 10 U.S. communities. Using content analysis, we identified and grouped the most common barriers that emerged in focus group discussions.

Results: We identified nine major themes reflecting issues related to patients' ability to care for and manage their heart conditions. We grouped the themes into three domains of interest: (1) barriers that interfere with getting necessary services, (2) barriers that impede the monitoring and management of a heart condition on a daily basis, and (3) supports that enable self-management and improve care.

Conclusion: For disadvantaged populations, typical problems associated with self-management of a heart condition are aggravated by substantial obstacles to accessing care.

Practice implications: Ensuring disadvantaged patients with chronic heart conditions are linked to formal systems of care, such as cardiac rehabilitation programs, could better develop patients' self-management skills, reduce barriers to receiving care and improve the overall health outcomes of these patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Chronic Disease
  • Continuity of Patient Care
  • Disease Management
  • Female
  • Focus Groups
  • Health Services Accessibility*
  • Health Services Needs and Demand
  • Health Status Disparities*
  • Heart Diseases / rehabilitation*
  • Humans
  • Male
  • Medically Underserved Area
  • Middle Aged
  • Patient Satisfaction*
  • Self Care*
  • Social Support
  • Treatment Outcome
  • United States
  • Young Adult