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Views of Patients With Heart Failure on Their Value-Based Self-care Decisions: A Qualitative Study
Journal of Cardiovascular Nursing  (IF2.083),  Pub Date : 2020-11-01, DOI: 10.1097/jcn.0000000000000733
Mehri Karimi-Dehkordi, Alexander M. Clark

Background 

Self-care adherence remains low in patients with heart failure (HF); little is known about the influence of patients' values on self-care decisions and behaviors.

Objectives 

The aim of this study was to explore how participants living with HF perceive their values and how those values are reportedly expressed in self-care decision making.

Methods 

The Interpretative Phenomenological Analysis approach was used. Semistructured interviews were conducted with 12 patients 60 years or older; with New York Heart Association class II and III HF; and able to speak, read, and understand English. Participants recruited via convenience sampling (January–December 2016) from 2 urban sites in Western Canada.

Results 

Values were reported to pivotally influence HF self-care decisions and behaviors. Overarching themes addressed aspects of values and decision making: notably, directness and complexity. Two main types of values, functional and emotional values, were involved in both adherent and nonadherent decisions. Values were often in flux, with the pursuit of these values being frequently in conflict with physical ability and changing over time.

Conclusion 

Two types of values serve influence self-care decisions and adherence. As HF and its self-care prevent patients from pursuing their prioritized values, patients are often nonadherent. Thus, patients with HF should be supported to find alternative ways to enact their values.