J Cardiovasc Nurs. 2022;37(6):515-529. doi: 10.1097/JCN.0000000000000919. Epub 2022 Apr 27.
Many studies of heart failure (HF) self-care have been conducted since the last update of the situation-specific theory of HF self-care.
The aim of this study was to describe the manner in which characteristics of the problem, person, and environment interact to influence decisions about self-care made by adults with chronic HF.
This study is a theoretical update. Literature on the influence of the problem, person, and environment on HF self-care is summarized.
Consistent with naturalistic decision making, the interaction of the problem, person, and environment creates a situation in which a self-care decision is needed. Problem factors influencing decisions about HF self-care include specific conditions such as cognitive impairment, diabetes mellitus, sleep disorders, depression, and symptoms. Comorbid conditions make HF self-care difficult for a variety of reasons. Person factors influencing HF self-care include age, knowledge, skill, health literacy, attitudes, perceived control, values, social norms, cultural beliefs, habits, motivation, activation, self-efficacy, and coping. Environmental factors include weather, crime, violence, access to the Internet, the built environment, social support, and public policy.
A robust body of knowledge has accumulated on the person-related factors influencing HF self-care. More research on the contribution of problem-related factors to HF self-care is needed because very few people have only HF and no other chronic conditions. The research on environment-related factors is particularly sparse. Seven new propositions are included in this update. We strongly encourage investigators to consider the interactions of problem, person, and environmental factors affecting self-care decisions in future studies.
自上次心力衰竭（HF）自我护理特定情况理论更新以来，已经进行了许多 HF 自我护理研究。
本研究旨在描述问题、人与环境的特征如何相互作用，影响慢性 HF 成人的自我护理决策。
这是一项理论更新。总结了关于 HF 自我护理的问题、人与环境影响的文献。
与自然决策一致，问题、人与环境的相互作用创造了需要自我护理决策的情况。影响 HF 自我护理决策的问题因素包括认知障碍、糖尿病、睡眠障碍、抑郁和症状等特定情况。合并症使 HF 自我护理因各种原因变得困难。影响 HF 自我护理的个体因素包括年龄、知识、技能、健康素养、态度、感知控制、价值观、社会规范、文化信仰、习惯、动机、激活、自我效能和应对。环境因素包括天气、犯罪、暴力、互联网接入、建筑环境、社会支持和公共政策。
关于影响 HF 自我护理的个体相关因素，已经积累了大量知识。需要更多关于与问题相关因素对 HF 自我护理贡献的研究，因为很少有人只有 HF 而没有其他慢性疾病。关于环境相关因素的研究尤其稀疏。本更新包含七个新命题。我们强烈鼓励研究人员在未来的研究中考虑影响自我护理决策的问题、人与环境因素的相互作用。
