The Relationship Between Fatigue and Self-care in Adults With Heart Failure: A Scoping Review

Adults with heart failure (HF) have complex treatment plans that require effective self-care behaviors to prevent disease progression. However, engagement in consistent self-care behaviors is often poor. Fatigue, a highly distressing symptom, can interfere with complex decision making required for and consistent engagement in self-care behaviors.

The aims of this study were to provide a comprehensive overview of the existing literature describing the relationship between fatigue and self-care in adults with HF and to identify gaps and propose areas for future research.

Guided by the situation-specific theory of heart failure self-care, a systematic search of Scopus, CINAHL, and PubMed was conducted to identify primary studies published between 2014 and 2025 in which authors examined the relationship between fatigue and self-care.

Of the 2107 studies identified, 19 met inclusion criteria. The majority identified participants being 50 to 70 years old and mostly male, and having an ejection fraction of ≤40% or having HF with a reduced ejection fraction. Seven different unidimensional measures of fatigue and 10 measures of self-care were identified. Fatigue was recognized as a barrier to self-care maintenance, self-care monitoring, and self-care management. Most study authors used a cross-sectional, nonexperimental, descriptive, or qualitative design.

Fatigue is a prevalent symptom that can negatively affect self-care among individuals with HF. There is variability in the conceptual and operational definition of fatigue and self-care, making it difficult to compare these variables across studies. Future studies in which authors measure the multidimensionality of fatigue are needed in addition to longitudinal studies that may capture the temporal nature of fatigue and self-care.