Cognitive dysfunction and self-care decision making in chronic heart failure: A review of the literature

Background: Memory and executive function may be associated with poorer self-care management behaviors (indicators of self-care decision making). Dysfunction of self-care decision making processes often results in worsening of heart failure symptoms that necessitates hospitalization for acute management. Aims: The purposes of this literature review are to (a) synthesize the published literature (2000-2012) examining the relationship between cognitive dysfunction (CD) (executive function and memory) and self-care management decisions in heart failure (HF) patients; (b) identify gaps in knowledge; and (c) provide recommendations for future research to fill this gap. Methods: Literature from January 2000-September 2012 was reviewed to determine the relationship between cognitive dysfunction and self-care decision making in patients with HF. Studies were included that used measures to examine the relationship between cognitive dysfunction and self-care decision making in patients with HF. Results: The ability to identify a significant relationship between CD and self-care decision making processes was limited by the paucity of studies, small sample sizes, use of convenience samples and the use of single center recruitment sites. Conclusion: Despite the importance of memory and executive function in decision making, there is a paucity of studies describing the relationship between CD and self-care decision making processes. A knowledge gap exists regarding the relationship between CD and self-care decision making processes. The influence of executive function and memory on self-care decision making abilities needs further study in diverse populations, using standardized and valid measures for CD and self-care decision making processes.