Self-care among older Chinese people with chronic heart failure: the roles of cognitive and psychosocial characteristics

Chronic heart failure (CHF) is a complex clinical syndrome resulting from inefficient myocardial pumping, and is characterised by a typical progressively deteriorating trajectory punctuated by serious episodes of acute disease decompensation. High prevalence of hospital admission has been reported. However, around 40% of hospital admissions was avoidable if patients demonstrate consistent self-care.  Research in the last decade identified various barriers at the patient-, providerand system-level for effective selfcare. Among these barriers, those at the patient-level are most complicated. Apart from lacking of knowledge and resources, cognitive and psychosocial factors such as illness perception, mood status, self-esteem, sense of control, etc., also influence ones’ self-care decision making process and behaviors. Previous research mainly adopted quantitative approach to understand the nature and the strengths of associations between patient-level factors and self-care, least in-depth exploration has been done to reveal the complexity about how and why these factors shape self-care. The qualitative study was to explore how cognitive and psychosocial characteristics of the HF patients affect their self-care. Cognitive characteristics referred but not limited to health beliefs and knowledge whereas psychosocial characteristics referred to self-confidence, self-esteem, mood status, social support, satisfaction with professional care, etc. A purposive sample of 30 HF patients was recruited from the cardiology out-patient clinics of a regional hospital in Hong Kong. Eligible participants were: (1) diagnosed by a cardiologist as having HF for at least six months; (2) with New York Heart Association (NYHA) Class II–IV symptoms; (3) Chinese ethnicity, and (4) able to communicate. Sample variation in socio-demographic and clinical profiles