Factors associated with self-care behavior among heart failure patients in India: A systematic review.

Self-care is crucial for heart failure management and complements pharmacological treatments; however, various factors hinder effective self-care, adversely affecting clinical outcomes and leading to poor quality of life. This systematic review aimed to identify factors influencing self-care behaviors among heart failure patients in India. The search was conducted in six databases, PubMed, CINAHL, Scopus, ProQuest, Web of Science, and Embase; between January 2012 and September 2024, 676 articles were reviewed. After removing duplicates, seven articles were included for analysis on the basis of the study inclusion criteria. The PRISMA guidelines has been used in this review. We included observational, cross-sectional, experimental, quasiexperimental, and qualitative studies published in English and conducted in India. The included studies were critically appraised using the Joanna Briggs Institute's risk of bias tool. The data were synthesized narratively. The findings revealed various factors that influence self-care behavior, which were divided into favorable and hindering factors. The factors that favored self-care behavior were self-efficacy, disease-related knowledge, situational awareness, adequate family income, financial support, health insurance, supportive family, patient willpower, and confidence in healthcare. However, low education, lack of knowledge about heart failure, difficulty understanding health information, limited time spent by healthcare providers, low health literacy, low self-efficacy, financial difficulties, negative emotions, and lack of structured care plans hindered self-care. These findings underscore the need for health policies that prioritize patient education, accessible care and adequate financial support. Strengthening such policies could improve self-care adherence among heart failure patients, enhancing clinical outcomes and quality of life.