Context matters in heart failure self-care: A qualitative systematic review

Patricia H. Strachan, Kay Currie, Karen Harkness, Melisa Spaling, Alexander M. Clark

Research output: Contribution to journalReview articlepeer-review

60 Citations (Scopus)


Background The aim of this work was to identify the main contextual factors and processes that influence patients' self-care of heart failure (HF). Methods and Results A systematic review was conducted with the use of qualitative meta-synthesis. Ten databases were searched up to March 19, 2012. Of the 1,421 papers identified by the systematic search, 45 studies were included in this meta-synthesis. To be included, studies had to contain a qualitative research component, data pertaining to self-care of HF from adults (≥ 18 y) and be published as full papers or theses since 1995. These studies involved: 1,398 patients (mean age 65.9 y), 180 caregivers, and 63 health professionals. Six main types of contextual factors were found to influence HF self-care in the studies: caregivers; social networks and social support; place; finances and financial capacity; work and occupation; and HF support groups and programs. Conclusion HF self-care is influenced by contextual elements that fall outside of traditional elements of a HF self-care program. Inclusion of these elements may help to address the current concerns about poor adherence to self-management programs.

Original languageEnglish
Pages (from-to)448-455
Number of pages8
JournalJournal of Cardiac Failure
Issue number6
Publication statusPublished - Jun. 2014


  • Heart failure
  • context
  • meta-synthesis
  • self-care


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