The Disease Self-Management Among Patients With Chronic Heart Failure in an Affluent Economy: A Grounded Theory Study.

Aims: To examine the difficulties patients with chronic heart failure face in managing their condition, as well as the coping strategies they employ to overcome these difficulties.

Design: Grounded theory qualitative research.

Methods: Participants were selected using purposive sampling followed by theoretical sampling. Face-to-face semi-structured interviews were conducted with fifteen patients diagnosed with chronic heart failure and three of their family members. Data analysis involved a three-level coding technique of constant comparison to identify core categories.

Results: The core category Gaining Control of Life was identified from the data, encompassing two main themes: factors influencing disease self-management and self-management strategies. Factors affecting disease self-management were identified at three levels: individual, family and societal. Self-management strategies applied by patients primarily focused on three domains: disease management, lifestyle adjustments and emotional regulation. Filial piety and familial care, combined with adequate and accessible local healthcare services, enhanced patients' sense of control, integrating disease management into their everyday lives.

Conclusion: The self-management experiences of patients with chronic heart failure represent an ongoing process of learning and adaptation, deeply influenced by socio-cultural factors. Through this adjustment process, patients continuously develop their coping skills, ultimately achieving the goal of gaining control of life. Comprehensive and accessible healthcare and community support play a pivotal role in facilitating this adaptation. The findings of this study contribute to the enrichment of existing self-care theories by highlighting the interplay between individual, familial and societal factors.

Impact: This study aligns with and integrates key elements of Roy's Adaptation Model and Orem's Self-Care Theory while emphasising the collaborative roles of patients, families and society in disease management.

Implications for patient care: Enhance the quality of life of patients with chronic diseases, enabling them to take control of their lives more effectively.

Patient or public contribution: Fifteen patients diagnosed with chronic heart failure and three family members agreed to participate in the study and shared their experiences with us.