Self-care model based on the theory of unpleasant symptoms in patients with heart failure

Aims: This study aimed to test and develop the self-care model based on the theory of unpleasant symptoms in patients with HF. Background: Although self-care may reduce unpleasant symptoms of heart failure (HF), reported rates of effective self-care in HF patients are very low. Modifiable factors, including disease severity, anxiety, depression, social support, unpleasant symptoms, and self-efficacy are considered to influence self-care, but little is known about their overall impact on self-care. Methods: A model-testing design was used. Covariance structure analysis using the maximum likelihood method was used to evaluate the hypothetical model. Results: A total of 209 subjects participated in the study. The model-fit indexes of the final model were chi(2) = 163.473, Normed chi(2) = 1.796, RMSEA = 0.054, IFI = 0.986, CFI = 0.986, GFI = 0.915, and AGFI = 0.873. Disease severity and anxiety had an indirect effect on self-care through unpleasant symptoms. Depression and social support had an indirect effect on self-care through self-efficacy. Lower unpleasant symptoms and higher self-efficacy were associated with greater self-care. These predictors explained 61.9% of variance in self-care. Conclusion: Findings from this study could underscore the need to consider nursing strategies that relieve unpleasant symptoms and improve self-efficacy to enhance self-care in HF patients.