Congestive heart failure self-management among US veterans: The role of personal and professional advocates

ObjectiveUnderstand patients' experiences with primary care services for congestive heart failure (CHF) and explore the relationship between health services and self-management.MethodsWe conducted semi-structured interviews with thirty-nine patients with CHF receiving care at one Veterans Affairs Medical Center (VA). We analyzed data using thematic content analysis.ResultsParticipants acknowledged the importance of ongoing engagement in the plan of care for CHF. They attributed success in this effort to be greatly influenced by personal advocates. The advocates included both members of the healthcare team with whom they had a continuity relationship and friends or family members who assisted on a daily basis. Participants also identified psychological symptoms as a major barrier to carrying out self-care.ConclusionPatients identify relationships with health care workers, help from family and friends, and mental health problems as major influences on the ability to manage their CHF.Practice implicationsEfforts to optimize CHF self-management should attend to health system and psychosocial barriers to care.