Positive psychological constructs and health behavior adherence in heart failure: A qualitative research study

Nurs Health Sci. 2020 Sep;22(3):620-628. doi: 10.1111/nhs.12704. Epub 2020 Mar 22.


Psychological well-being may play an important role in health behavior adherence and cardiovascular health, but there has been limited study of well-being in patients with heart failure. In this descriptive qualitative research study, we interviewed 30 patients with heart failure to explore their psychological experiences with heart failure and the perceived associations between positive psychological constructs and adherence to physical activity, diet, and medication recommendations. Interviews were transcribed, then coded in NVivo using directed and conventional content analysis, and the Consolidated Criteria for Reporting Qualitative Research checklist was applied to report our findings. Participants spontaneously reported positive psychological constructs both during an acute phase of illness and 3 months later. Participants most commonly experienced gratitude, acceptance, connectedness, and faith in the setting of heart failure. In contrast, pride, determination, and hope were identified most frequently as playing a role in health behavior adherence. Finally, participants reported a reinforcing relationship between positive constructs and health behavior engagement. These findings suggest that interventions to boost positive constructs have the potential to improve well-being and health behavior adherence in patients with heart failure.

Keywords: health behavior adherence; heart failure; optimism; positive affect; qualitative research.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Health Behavior
  • Heart Failure / complications
  • Heart Failure / psychology*
  • Humans
  • Interviews as Topic / methods
  • Male
  • Middle Aged
  • Qualitative Research
  • Treatment Adherence and Compliance / psychology*
  • Treatment Adherence and Compliance / statistics & numerical data