The self-care coping process in patients with chronic heart failure: A qualitative study

J Clin Nurs. 2019 Feb;28(3-4):509-519. doi: 10.1111/jocn.14640. Epub 2018 Aug 28.

Abstract

Aim: To understand the self-care coping process among chronic heart failure patients.

Background: Previous studies have been carried out to understand the experience and the challenges of living with chronic heart failure. However, the coping processes that patients use to overcome self-care challenges are less understood.

Design: A qualitative design with qualitative content analysis of data was employed.

Methods: Purposive sampling was conducted to recruit inpatients with chronic heart failure between March 1, 2014-March 1, 2015, in a teaching hospital in Taiwan. Semi-structured interviews (N = 27) were completed, and a content analysis was performed using an inductive method to explore the self-care coping processes in patients with chronic heart failure.

Results: The findings were categorised into three themes: (a) responding to chronic heart failure self-care (dealing with negative emotions, accepting reality and struggling between a self-care regime and self preference), (b) finding ways to live with chronic heart failure (enhancing understanding and knowledge about chronic heart failure, maintaining outer and inner self, engaging positively/negatively with others and relying on religious thoughts and seeking consolation) and (c) reinterpreting chronic heart failure and performing meaning-oriented coping (re-evaluating the meaning of life, assigning a new perspective for chronic heart failure and discovering a deeper meaning behind it).

Conclusion: Self-appearance concerns should be given more attention by healthcare professionals. Meaning-oriented coping was found to be helpful to cope with the challenges of chronic heart failure. Thus, there is a need to develop interventions associated with meaning-oriented coping to enhance coping strategies for chronic heart failure patients.

Relevance to clinical practice: It is suggested for healthcare professionals to understand an individual's coping process and support people with chronic heart failure who struggle with self-care coping. Furthermore, specific interventions including meaning-oriented interventions might benefit people with chronic heart failure to cope more successfully.

Keywords: chronic heart failure; coping process; nursing; qualitative study; self-care.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Body Image
  • Chronic Disease
  • Female
  • Heart Failure / psychology*
  • Humans
  • Male
  • Middle Aged
  • Qualitative Research
  • Self Care / psychology*
  • Taiwan