Motivation to Engage in Self-Care of Heart Failure: An Ecological Momentary Assessment

Heart failure (HF) is associated with substantial morbidity and mortality worldwide. Although self-care is crucial for long-term HF management, individuals with HF often face challenges in maintaining self-care behaviors over time. This highlights the need to understand people's motivation to engage in self-care and how those motivations might change over time. Self-determination theory provides a valuable framework for understanding the link between motivation and self-care, but the specific conditions that shape this relationship in daily life remain uncertain.

An ecological momentary assessment study was conducted to investigate the relationship between intention and self-care among patients with HF, as well as the moderating role of motivation types.

Participants completed 2 surveys per day for a week using the Sema3 mobile application.

A total of 63 patients with HF (49.2% male) with a mean age of 61.7 years (standard deviation = 17.1) completed the study. Medication adherence demonstrated high stability (intraclass correlation coefficient [ICC] = 0.99) in daily life, while diet (ICC = 0.80) and weighing behaviors (ICC = 0.79) were also largely consistent within participants. In contrast, exercise demonstrated greater day-to-day fluctuation (ICC = 0.46). Morning self-care intentions significantly predicted evening behaviors for weighing and exercise, but not for diet-related self-care. Identified and integrated motivation were the most commonly endorsed types of motivation across different self-care behaviors.

This study highlighted the dynamic nature of motivation and self-care in daily life. Health professionals should recognize that intention does not necessarily translate into actual behavior, and some behaviors require greater support than others.