Factors influencing self-care behaviours in patients with heart failure: A mixed-methods systematic review

Self-care is critical for patients with heart failure (HF) to reduce rehospitalization, improve survival, and enhance quality of life. However, adherence to self-care during recovery is often suboptimal and influenced by multiple determinants.

To systematically identify the determinants of self-care behaviors in patients with HF and provide evidence to inform the development of tailored intervention strategies.

Five databases (PubMed, Web of Science, Cochrane Library, Embase, and CINAHL) were searched from inception to April 2025. Eligible studies were synthesized and analyzed using a convergent integrated approach.

A total of 56 studies were included (34 quantitative, 19 qualitative, and 3 mixed-methods). Five major categories of determinants were identified: (1) sociodemographic factors, (2) health-related factors, (3) psychological and social factors, (4) personal health perceptions and decision-making in sociocultural context and (5) economic and knowledge-related factors.

Self-care behaviors among patients with HF are shaped by a complex interplay of multidimensional factors. The findings highlight the necessity for multifaceted, context-sensitive interventions that account for individual psychosocial profiles, cultural contexts, and resource accessibility to enhance self-management and adherence.