Heart failure patients' attitudes, beliefs, expectations and experiences of self-management strategies: a qualitative synthesis

Chronic Illn. 2014 Jun;10(2):135-54. doi: 10.1177/1742395313502993. Epub 2013 Oct 1.


Objectives: To develop a model of heart failure patients' attitudes, beliefs, expectations, and experiences based on published qualitative research that could influence the development of self-management strategies.

Methods: A synthesis of 19 qualitative research studies using the method of meta-ethnography.

Results: This synthesis offers a conceptual model of the attitudes, beliefs, and expectations of patients with heart failure. Patients experienced a sense of disruption before developing a mental model of heart failure. Patients' reactions included becoming a strategic avoider, a selective denier, a well-intentioned manager, or an advanced self-manager. Patients responded by forming self-management strategies and finally assimilated the strategies into everyday life seeking to feel safe.

Discussion: This conceptual model suggests that there are a range of interplaying factors that facilitate the process of developing self-management strategies. Interventions should take into account patients' concepts of heart failure and their subsequent reactions.

Keywords: Heart failure; attitudes; cardiac rehabilitation; experience; meta-ethnography; qualitative synthesis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Anthropology, Cultural
  • Chronic Disease
  • Disease Management
  • Female
  • Health Behavior
  • Health Knowledge, Attitudes, Practice*
  • Heart Diseases / psychology*
  • Heart Diseases / therapy*
  • Humans
  • Male
  • Models, Psychological*
  • Qualitative Research
  • Self Care / methods*
  • Self Efficacy*
  • Severity of Illness Index