Understanding Self-Care Coping Styles in Patients with Chronic Heart Failure

Background: Heat failure (HF) is a serious disease with poor prognosis and large numbers of people suffer from heart failure around the world. The physical and psychological self-care coping styles affect the quality of life (QoL) among patients with chronic HF. The decreasing of physical and psychological functioning often contributes to poor QoL. Therefore, it is important to understand the coping styles and the related factors in physical and psychosocial self-care. 

Purpose:  1) To understand the coping of self-care in physical and psychological aspects in chronic HF patients; and 2) To understand the associated factors with the coping of self-care. 

Methods: A literature review with the database PubMed (1984-2013), CINHAL (1988-2013) and PsycINFO (1967-2013), and Airti Library (1984-2013) were searched. The Strengthening the Reporting of Observational Studies in Epidemiology and the Critical Appraisal Skills Program were used to assess the quality of studies.   

Results: In total, 26 studies were included. Seven studies investigated the impact of coping of physical self-care, eleven studies investigated the association of coping of psychological self-care and eight studies were explored both coping of physical and psychological self-care. Emotion-focused coping (i.e., acceptance and disavowal) and problem-focused coping are positively associated better physical and psychological self-care; whereas, emotional approach with escape-avoidance was negatively related to adaptive self-care. To enhance the use of emotion-focused coping with acceptance could facilitate the use of problem-focused coping to cope with the physical self-care such as medication and dietary adherence and reducing adverse drug effects. The influencing factors in coping styles of physical and psychological self-care included the demographic (age, gender, ethnic, marital status), underlying disease, personality, disease management knowledge level, self-care confidence and social support.

Conclusion: This paper presents an integrative review of the literature on understanding self-care coping styles in patients with chronic heart failure. Emotion-focused coping with acceptance and disavowal, and problem-focused coping may positively influence physical and psychological self-care. Health professionals could educate acceptance and disavowal skills, and then it may facilitate the using problem-focused coping skills among HF patients. The influencing factors have important roles on individual’s coping styles, but lacking of the study to explore how the influencing factors affect the coping of self-care.