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Comparison of self-care behaviors of heart failure patients in 15 countries worldwide
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0002-4259-3671
Rabin Medical Centre, Israel.
Australian Catholic University, Australia.
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2013 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 92, no 1, 114-120 p.Article in journal (Refereed) Published
Abstract [en]


Clinicians worldwide seek to educate and support heart failure patients to engage in self-care. We aimed to describe self-care behaviors of patients from 15 countries across three continents.


Data on self-care were pooled from 5964 heart failure patients from the United States, Europe, Australasia and South America. Data on self-care were collected with the Self-care of Heart Failure Index or the European Heart Failure Self-care Behavior Scale.


In all the samples, most patients reported taking their medications as prescribed but exercise and weight monitoring were low. In 14 of the 22 samples, more than 50% of the patients reported low exercise levels. In 16 samples, less than half of the patients weighed themselves regularly, with large differences among the countries. Self-care with regard to receiving an annual flu shot and following a low sodium diet varied most across the countries.


Self-care behaviors are sub-optimal in heart failure patients and need to be improved worldwide.

Practice implications

Interventions that focus on specific self-care behaviors may be more effective than general educational programs. Changes in some health care systems and national policies are needed to support patients with heart failure to increase their self-care behavior.

Place, publisher, year, edition, pages
Elsevier, 2013. Vol. 92, no 1, 114-120 p.
Keyword [en]
Self-care, International, Disease management, Heart failure, Cardiac
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-95952DOI: 10.1016/j.pec.2013.02.017ISI: 000321483700017OAI: diva2:641718
Available from: 2013-08-19 Created: 2013-08-12 Last updated: 2014-10-10

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Jaarsma, TinyStrömberg, AnnaKato, Naoko
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Division of Health, Activity and CareFaculty of Health SciencesDivision of Nursing ScienceDepartment of Cardiology in Linköping
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