Date of Award
10-13-2025
Degree Type
Thesis
Degree Name
MSc in Nursing
First Advisor
Dr Laila Ladak
Second Advisor
Ambreen Gowani
Third Advisor
Dr Nasir Rahman
Department
School of Nursing and Midwifery, Pakistan
Abstract
Background: Heart failure is a significant problem affecting individuals globally, including Pakistan, leading to increased morbidity, hospital readmission, and decreased quality of life. Effective self-care in managing both types of reduced and preserved ejection fraction of heart failure is therefore essential.
Purpose: The study aims to explore self-care approaches of patients with heart failure with preserved ejection fraction and reduced ejection fraction.
Research Methodology: A qualitative descriptive study design was used to explore the self-care approaches among patients with HFrEF and HFpEF of heart failure at a tertiary care hospital in cardiology outpatient clinics in Karachi, Pakistan. A total of 18 patients, nine patients of each HFrEF and HFpEF with heart failure, were interviewed face-to-face, And Directed content analysis, a middle-range theory of self-care of chronic illness, was used to analyse the findings of the study.
Results: The study analysed self-care approaches from heart failure reduced ejection fraction (HFrEF) and heart failure preserved ejection fraction (HFpEF), across three themes: self-care maintenance, self-care monitoring and self-care management. In the selfcare maintenance theme, medication adherence, appropriate salt, fluid intake, and healthy fats were identified. HFrEF patients used a pill box strategy to ensure medication compliance; they also reported that they were unable to exercise due to tiredness and relied on family support for self-care. In contrast, HFpEF patients had confidence in managing their self-care independently. In the self-care monitoring theme, both groups tracked their blood pressure, blood sugar, checked their weight, oedema and performed recommended screening. In self-care management, HFpEF participants demonstrated confidence and strong coping mechanisms. However, many HFrEF participants found medications burdensome, expressed worries and faced difficulties.
Conclusion: Self-care approaches in heart failure patients include diet control, medication adherence and family support. reporting proper monitoring, including blood pressure, blood sugar level and checking oedema. Additionally, patients with other comorbidities struggled to manage their disease. The findings of the study suggest reducing the burden of polypharmacy by reviewing and optimising medications. Moreover, the study suggests improving continuity of care through government healthcare facilities to reduce readmissions, decrease the economic burden, and improve the quality of life.
First Page
1
Last Page
135
Recommended Citation
Zameen, B. S.
(2025). Self-care approaches among patients with reduced and preserved ejection fraction of heart failure at a tertiary care hospital in Karachi. A qualitative study. , 1-135.
Available at:
https://ecommons.aku.edu/etd_pk_sonam_mscn/267