TABLE 1.
Information of the inclusion study.
| Study | Country | Design (type) | Setting/location | Sample size | Main outcome | The main propositions put forward | Whether to validate | Subject affiliation |
|---|---|---|---|---|---|---|---|---|
| Barbara Riegel et al. (2012) | US | It is based on the Situation‐Specific theory (review) | Three hypotheses and seven propositions are proposed | Not mentioned | A Middle‐Range Theory of Self‐Care of Chronic Illness | The key concepts include self‐care maintenance, self‐care monitoring and self‐care management. Factors influencing self‐care including experience, skill, motivation, culture, confidence, habits, function, cognition, support from others and access to care are described | No | Advances in Nursing Science |
| Tiny Jaarsma et al. (2017) | US | Take the form of a review (summary) | Summarize the recent heart failure literature on these related factors in order to provide an overview on which factors might be suitable to be considered to make self‐care interventions more successful | 14 studies | Update of Riegel's middle‐range Theory | Experiences and skills, motivation, habits, cultural beliefs and values, functional and cognitive abilities, confidence and support and access to care are all important to consider when developing or improving interventions for patients with heart failure and their families | No | Curr Heart Fail Rep |
| Sumayya A. Attaallah et al. (2021) | US | After integrating theoretical and empirical literature, a hypothetico‐deductive approach was used to develop theory (review) | Describes the strategy used in developing a middle‐range theory of heart failure self‐care. After integrating theoretical and empirical literature, a hypothetico‐deductive approach was used to develop the middle‐range theory of heart failure self‐care from Orem's theory of self‐care | Not mentioned | Middle‐Range Theory of Heart Failure Self‐Care | 7 associated proposition for the MRT of HF self‐care were mentioned | No | Nursing Science Quarterly |
| Sumayya A. Attaallah et al. (2021) | US | A middle‐range theory of heart failure self‐care, derived from the self‐care deficit theory of nursing, was tested among 175 Arab American older adults with heart failure (descriptive research) | 175 patients were recruited from four cardiology clinics. Instruments to assess HF influential factors include a personal survey, health care index, the Center for Epidemiological Studies‐Depression Scale‐10, Arabic‐Speaking Patients' Acculturation Scale and Medical Outcomes Study Social Support Survey | 175 patients | Testing a Middle‐Range Theory of Heart Failure Self‐Care | Conceptualizing basic conditioning factors as a single latent variable was not supported. However, individual factors of depression, social support and time living with heart failure had a direct effect on both self‐care agency and quality of life | Yes | Nursing Science Quarterly |
| Barbara Riegel et al. (2008) | US | Four propositions were derived from the self‐care of heart failure conceptual model. These propositions were tested and supported using data obtained in previous research (descriptive research) | Naturalistic decisions are involved. Crucial elements included a nursing perspective; a clear link among the theory, research and clinical practice; and a conceptual scheme based on abstract thinking, memo or journal writing and dialogue with colleagues, students and research participants | 760 patients | A Situation‐Specific Theory of Heart Failure Self‐care | Two concepts of self‐care management and self‐care maintenance were proposed. Confidence is thought to influence the self‐care process in important ways | Yes | Cardiovascular Nursing |
| Barbara Riegel et al. (2016) | US | Describe this revised, updated situation‐specific theory of HF self‐care. A total of 5 assumptions and 8 testable propositions are specified in this revised theory (review) | Designing the middle‐range theory and studying the literature citing the situation‐specific theory led us to conclude that this theory needs revision and updating. Propose propositions and hypotheses, search databases, search literature using context‐specific theories and test propositions and hypotheses | 85 relevant articles were retained | Updated situation‐specific theory of HF self‐care | A third concept, symptom perception, has been added to the theory; each process includes both autonomous and consultative elements; this revised theory is more closely integrated with the naturalistic decision‐making elements of person, problem and environment and with the self‐care decisions made by patients with HF while acknowledging how these decisions are influenced by knowledge, skills, experience and values | Partly | Cardiovascular Nursing |
| Barbara Riegel et al. (2022) | US | Describe the manner in which characteristics of the problem, person and environment interact to influence decisions about self‐care made by adults with chronic HF.(review) | Literature on the influence of the problem, person and environment on HF self‐care is summarized | Not mentioned | Updated situation‐specific theory of HF self‐care |
We know that the problem, person and environment influence self‐care decisions, but here, we emphasize the interaction among these three factors New emphasis is placed on environmental factors influencing self‐care: weather, crime, violence, access to the Internet, the built environment, social support and public policy Seven new theoretical propositions are included in this update |
No | Journal of Cardiovascular Nursing |
| Ercole Vellone et al. (2017) | Italy | Describe a Situation‐Specific Theory of Caregiver Contributions to HF Self‐care (descriptive research) | Describe theoretical assumptions, recursive pathways are hypothesized between processes and outcomes. Ten theoretical propositions are proposed | Not mentioned | A Situation‐Specific Theory of Caregiver Contributions to Heart Failure Self‐care | Caregiver contributions to HF self‐care include interacting processes of self‐care maintenance, symptom monitoring and perception and self‐care management. Caregiver confidence and cultural values are discussed as important influences on caregiver contributions to HF self‐care | No | Journal of Cardiovascular Nursing |
| Oliver Rudolf Herber et al. (2018) | Germany | Used meta‐synthesis techniques to integrate statements of findings pertaining to barriers and facilitators to heart failure self‐care that were derived previously through meta‐summary techniques leading to a new situation‐specific theory (meta‐synthesis) | Developed the theory based on the statements of findings that were derived through meta‐summary techniques. The integration process involved the use of ‘imported concepts’ which are generally accepted as true to address our phenomena. Finally, the theory was refined through continuous discussions | 37 initially, 814 patients | A situation‐specific theory pertaining to barriers (−) and facilitators (+) for self‐care in patients with heart failure | According to our proposed theory, self‐care behaviour is the result of a patient's naturalistic decision‐making process. This process is influenced by two key concepts: ‘self‐efficacy’ and the ‘patient's disease concept of heart failure’ | No | Qualitative Health Research |
| Hui‐Wan Chuang et al (2019) | Taiwan | Examine how depressive symptoms, social support, eHealth literacy and heart failure (HF) knowledge directly and indirectly affect self‐care maintenance and management and to identify the mediating role of self‐care confidence in self‐care maintenance and management (descriptive research) | Analysed patient's data, including demographic and clinical characteristics, obtained from 5 scale. Then, path analysis was conducted to examine the effects of the study variables on self‐care maintenance and management | 141 patients | Self‐care confidence significantly and directly affected self‐care maintenance and management and mediated the relationships between factor variables (depressive symptoms, social support and HF knowledge) and outcome variables (self‐care maintenance and management) | Self‐care confidence decreases the negative effects of depressive symptoms on self‐care. This study underscores the need for interventions targeting patients' self‐care confidence to maximize self‐care among patients with HF | No | Journal of Cardiovascular Nursing |
| Yuanyuan Jin et al. (2021) | US | Describe the development of a situation‐specific nurse‐led culturally tailored self‐management theory for Chinese patients with HF (descriptive research) | An integrative approach was used as theory development strategy for the situation‐specific theory. The proposed theory is derived from Leininger's culture care theory (CCT) and Prochaska's transtheoretical model (TTM) | Not mentioned | Based on theoretical and empirical evidence and theorists' experiences from research and practice, a nurse‐led culturally tailored self‐management theory for Chinese patients with HF was developed | The situation‐specific theory developed in this study has the potential to increase specificity of existing theories while informing the application to nursing practice. Further critique and testing of the situation‐specific theory | No | Journal of Transcultural Nursing |
| Jennifer Wingham et al. (2014) | UK | Meta‐ethnography (qualitative research) | A multidisciplinary team of academics, clinicians and patient representatives in the United Kingdom | 19 qualitative research studies | Conceptual model of self‐management heart failure | Patients pass through five stages as they seek a sense of safety and well‐being when living with HF, including disruption, sense making, reaction, response and assimilation | No | Chronic illness |
| Elliane Irani et al. (2019) | US | Validate components of the Individual and Family Self‐management Theory among individuals with HF (descriptive research) | A path analysis was conducted to examine the indirect and direct associations among social environment, social facilitation and belief processes and self‐management behaviours while accounting for individual and condition‐specific factors | 370 patients | The Contribution of Living Arrangements, Social Support and Self‐efficacy to Self‐management Behaviours Among Individuals With Heart Failure | Support the Individual and Family Self‐management Theory, highlighting the importance of social support and self‐efficacy to foster self‐management behaviours for individuals with HF. Future research is needed to further explore relationships among living arrangements, perceived and received social support, self‐efficacy and HF self‐management | No | Journal of Cardiovascular Nursing |
| Barbara Riegel et al. (2011) | US | Validate the novice‐to‐expert self‐care typology and to identify determinants of the heart failure self‐care types (descriptive research) | Two‐step likelihood cluster analysis was used to classify patients into groups using all items in the maintenance and management scales of the Self‐care of Heart Failure Index. Multinomial regression was used to identify the determinants of each self‐care cluster, testing the influence of age and so on | 689 patients | Self‐care behaviours clustered best into three types | Duke Activity Status Index score and Self‐care of Heart Failure Index confidence score were the only statistically significant individual factors. Higher activity status increased the odds that patients would be inconsistent or novice in self‐care. Higher self‐care confidence increased the odds of being an expert or inconsistent in self‐care | No | Nursing Research |