Evid Based Nurs 7:127 doi:10.1136/ebn.7.4.127
  • Qualitative

Patients with heart failure had inadequate information about the disease and lacked the tools for optimal self care

 Q How do patients with congestive heart failure (CHF) perceive and understand the disease and self care?


Grounded theory.


An urban, academic, tertiary care hospital in the US.


19 patients (age range 52–89 y, 53% men) treated for CHF in the hospital, emergency department (ED), or internal medicine or cardiology clinics were identified from a database of inpatient and ambulatory encounters for CHF.


Patients participated in audiotaped semistructured interviews (mean duration 50 min), which were transcribed verbatim. Questions focused on patients’ illness perspectives, self care, help seeking behaviour, attitudes toward physicians, access to care, definition of and reaction to worsening of their condition, and a detailed description of their most recent critical episode of CHF, if one occurred. Dominant themes were identified by the constant comparative method and compared with the “common sense” model of illness.


3 dominant themes emerged. (1) Inadequate knowledge of the causes, symptoms, and consequences of CHF (gaps in depth and breadth). Patients did not connect CHF or a “weak heart” to their symptoms or understand acute and chronic CHF symptoms. Few labelled their illness as heart failure (lack of depth). Many …

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