A typology of heart failure self-care management in non-elders

Victoria Vaughan Dickson, Janet A. Deatrick, Barbara Riegel

Research output: Contribution to journalArticlepeer-review


Background: Heart failure (HF) self-care is extremely challenging and few people master it. Self-care was defined as an active, cognitive process in which persons engage for the purpose of maintaining their health (maintenance) and managing symptoms (management). Aim: To examine the contribution of attitudes, self-efficacy, and cognition to HF self-care management. Methods: In this mixed methods study, 41 individuals (63.4% male, 68.3% Caucasian, mean age 49.17 (10.51) years, 58.5% NYHA III, median ejection fraction 30%) were interviewed and completed instruments on HF self-care, cognition, and physical functioning. Content analysis of narrative data revealed themes of self-care management practices, attitudes and self-efficacy towards self-care. Non-parametric tests assessed differences based on the types identified in the content analysis. Results: A self-care typology was constructed from the data: experts, novices and inconsistent. There were statistically significant differences (p = 0.001) in self-care practices among types and variance in attitudes, self-efficacy, and cognition. Experts had experience and skill in self-care, which novices lacked, and positive attitudes and self-efficacy that aligned with their behaviors. Most patients (71%) were classified as inconsistent, a self-care type associated with impaired cognition, poor physical functioning, negative attitudes, and poor self-efficacy. Conclusions: This typology provides insight into how expertise in self-care develops and the reasons why it is not always sustained.

Original languageEnglish (US)
Pages (from-to)171-181
Number of pages11
JournalEuropean Journal of Cardiovascular Nursing
Issue number3
StatePublished - Sep 2008


  • Attitudes
  • Cognition
  • Heart failure
  • Self-care
  • Self-efficacy
  • Typology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medical–Surgical
  • Advanced and Specialized Nursing


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