• Patricia H Strachan, Kay Currie, Karen Harkness, Melisa Spaling, and Alexander M Clark.
• McMaster University, Hamilton, Ontario, Canada.
• J. Card. Fail. 2014 Jun 1; 20 (6): 448-55.

BackgroundThe aim of this work was to identify the main contextual factors and processes that influence patients' self-care of heart failure (HF).Methods And ResultsA systematic review was conducted with the use of qualitative meta-synthesis. Ten databases were searched up to March 19, 2012. Of the 1,421 papers identified by the systematic search, 45 studies were included in this meta-synthesis. To be included, studies had to contain a qualitative research component, data pertaining to self-care of HF from adults (≥18 y) and be published as full papers or theses since 1995. These studies involved: 1,398 patients (mean age 65.9 y), 180 caregivers, and 63 health professionals. Six main types of contextual factors were found to influence HF self-care in the studies: caregivers; social networks and social support; place; finances and financial capacity; work and occupation; and HF support groups and programs.ConclusionHF self-care is influenced by contextual elements that fall outside of traditional elements of a HF self-care program. Inclusion of these elements may help to address the current concerns about poor adherence to self-management programs.Copyright © 2014. Published by Elsevier Inc.

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