Self-Care Agency Power Components Among Patients with Heart Failure: A Qualitative Directed Content Analysis Based on the Orem Self-Care Theory

Background: Self-care is a self-regulatory action, which necessitates self-care power. Objectives: The current study aims at exploring self-care agency power components among patients with heart failure by the Orem self-care theory. Methods: The current qualitative study utilized content analysis approach based on the Orem self-care theory. Twenty-seven patients with heart failure and their family members were purposefully recruited from Shahid Rajaie cardiovascular center, Tehran, Iran. The study data were collected from December 2014 to May 2015 through in-depth semi-structured interviews. Data collection was continued until data saturation which was attained after the 24th interviews and hence, the last 3 interviews produced no new data. Data analysis was carried out by the directed content analysis approach proposed in 2005 by Hsieh and Shannon. Results: Data analysis yielded 79 primary codes, which represented the instances of self-care agency power components among patients with heart failure. The main components of self-care agency power were ability to acquire self-care knowledge, ability to identify factors aggravating heart failure, motivation for self-care, physical ability to engage in self-care activities, ability to adjust physical activities in order to save energy, ability to monitor bodily functions, reasoning about the causes of related symptoms, ability to decide on appropriate self-care measures, ability to understand the nature of the disease, ability to communicate with others to use their capabilities for self-care, ability to organize self-care measures, and ability to adhere to self-care activities. The most basic abilities are self-care knowledge, physical ability, and self-care motivation. Conclusions: The findings of the study indicated that effective self-care among patients with heart failure requires a wide range of self-care abilities. Nurses can use the findings to develop self-care plans for patients with heart failure.