Table 2.

Integrated results: Two exemplars of self-care change over time with illustrative quotes.

	Pre-Intervention/first session		Post-Intervention/last session
	Quantitative SCHFI	Qualitative Illustrative quotes	Quantitative SCHFI	Qualitative Illustrative quotes
Improved: Self-Care maintenance, Symptom recognition, Self-Care management and Self-Care confidence	Self-Care Maintenance: 57	“I ' m drinking tremendous amounts of fluid” “I wasn't taking water pill every single day… sometimes I miss two days or so … ” “I try to keep to <low salt diet>. What I try to do is maybe once a week eat a hoagie or steak sandwich … maybe only half of it”	Self-Care Maintenance: 80	“I'm only supposed to take in. 64 ounces. Don't drink any more than—than 64 ounces a day. I'm careful about that.” “ I don't play around with that <medication>…I read all about what it is, that I should take it” “I've been eating a lot more salads”
	Symptom Recognition: 0	“I just simply didn't feel it <symptoms>”	Symptom Recognition: 4	“… no episodes of shortness of breath since last time … but I would be able to tell”
	Self-Care Management: 30	“It came on and I called my brother to take me to emergency room”	Self-Care Management: 80	“If I start with <dyspnea> I stop what I'm doing… then call <doctor> if no better ”
	Self-Care Confidence: 67	“On a scale of 1 to 10…I am a 5 right in the middle…I can do it if I try”	Self-Care Confidence: 10 0	“ I know I can tell <worsening symptoms> because of the walking and the taking the diuretic regularly… ”
Summary: There was concordance between the quantitative and qualitative data. This participant improved in all elements of self-care.
Improved: Self-Care maintenance and Self-Care confidence No change: Sx recognition or Self-Care management	Self-Care Maintenance: 60	“…I eat TV dinners most days…?I don't buy fresh vegetables, I buy in the can but I rinse those … ”“we have Chinese food some days” “every day I drank my four glasses and if I am thirsty. I might take another cup” “<weighs> to see if I got water on me; fluid you know… but not every day … maybe when I think about it”	Self-Care Maintenance: 70	“I am taking my medicine” “… and eating right. not eating those fried foods and all that kind of fat … ‘<Weighs self> regularly, once a week’
	Symptom Recognition: 4	“… a real tight space. It is like I am in a box …”	Symptom Recognition: 4	“<last week> my legs were swollen and I felt tired”
	Self-Care Management: 55	“…if I gain like two or three pounds in a day; <doctor> wants me to come back”	Self-Care Management: 55	“…I decided myself that I was going to the emergency room…”
	Self-Care Confidence: 67	“I think I handle my diet pretty good …”	Self-Care Confidence: 78	“… just put your mind to it, and do it. I think I'm doing good … yes, I'm doing alright at this”
Summary: There was concordance between the quantitative and qualitative data. This participant improved in self-care maintenance and confidence primarily through improved diet and medication adherence. Although she did not weigh herself daily she did start to weigh herself regularly on a weekly basis. She was able to recognize her symptoms but remained unchanged in symptom management.

SCHFI=Self-care of Heart Failure Index. Note that scores are standardized 0–100. Symptom recognition scores are single items that range from 0 to 4.