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decision making, heart failure, patient-centered care, patients' values, self-care



  1. Karimi-Dehkordi, Mehri PhD, MScN, BScN
  2. Clark, Alexander M. RN, PhD, FCAHS


Background: Self-care adherence remains low in patients with heart failure (HF); little is known about the influence of patients' values on self-care decisions and behaviors.


Objectives: The aim of this study was to explore how participants living with HF perceive their values and how those values are reportedly expressed in self-care decision making.


Methods: The Interpretative Phenomenological Analysis approach was used. Semistructured interviews were conducted with 12 patients 60 years or older; with New York Heart Association class II and III HF; and able to speak, read, and understand English. Participants recruited via convenience sampling (January-December 2016) from 2 urban sites in Western Canada.


Results: Values were reported to pivotally influence HF self-care decisions and behaviors. Overarching themes addressed aspects of values and decision making: notably, directness and complexity. Two main types of values, functional and emotional values, were involved in both adherent and nonadherent decisions. Values were often in flux, with the pursuit of these values being frequently in conflict with physical ability and changing over time.


Conclusion: Two types of values serve influence self-care decisions and adherence. As HF and its self-care prevent patients from pursuing their prioritized values, patients are often nonadherent. Thus, patients with HF should be supported to find alternative ways to enact their values.