How do patients' values influence heart failure self-care decision-making?: A mixed-methods systematic review

Area of Science:

• Nursing
• Health Care
• Patient Self-Care

Background:

• Values are fundamental to ethical and effective healthcare.
• The influence of patient values on heart failure (HF) self-care is not well understood.

Purpose of the Study:

• To explore the role of patients' values in influencing self-care behaviors for individuals with heart failure.

Main Methods:

• A mixed methods systematic review using critical meta-narrative synthesis.
• Searched nine databases for studies published since 2000 on HF patients' values and self-care.
• Included 54 studies (qualitative, quantitative, and mixed methods) involving 6045 patients.

Main Results:

• Identified bidirectional interactions between heart failure, patient values, and self-care.
• Patients' self-care decisions are motivated by self-related (e.g., health, pleasure) and other-related (e.g., social recognition, responsibility) values.
• Conflicting values influence decision-making, with prioritized or blocked values shaping self-care actions.

Conclusions:

• Patient values are integral to heart failure self-care, affecting and responding to the condition.
• Values encompass personal, life, and social dimensions and are not uniform across individuals or healthcare providers.
• Future interventions must address the complex interplay of patient values and their impact on heart failure self-care behaviors.