Self-care management in patients with heart failure in Nakhon Si Thammarat Province, Thailand: a descriptive qualitative study

Abstract Heart failure remains a major global health burden, characterized by high mortality, frequent hospital readmissions, and poor quality of life. These outcomes are closely linked to inadequate self-care behaviors, limited patient knowledge, and insufficient ongoing support. This study aimed to describe self-care behaviors, self-awareness of severe symptoms requiring hospitalization, and symptom management strategies among patients with heart failure, and to provide evidence-based recommendations to inform improved care delivery. A descriptive qualitative study was conducted using individual in-depth interviews with 19 adults living with heart failure in community settings in Nakhon Si Thammarat Province, Thailand. Data were analyzed using content analysis to identify recurring patterns and themes related to self-care experiences. Three key themes were identified. (1) Self-care behaviors shaped patients’ lifestyles, with family caregiving influencing engagement in daily activities, medication adherence, and integrated self-care practices that supported physical and emotional well-being, knowledge-seeking, and healthcare support. (2) Self-awareness of severe symptoms requiring hospitalization, developed through continuous self-monitoring, was central to living with heart failure. Patients relied on physical sensations to guide symptom management, while engagement in daily activities reflected varying levels of self-care capacity or reliance on healthcare professionals. (3) Early self-management of symptoms supported timely rest, effective swelling control, and adherence to professional advice, contributing to reduced hospital readmission and mortality. Effective heart failure management requires individualized self-care approaches that are responsive to patients’ personal and cultural contexts. Enhanced self-awareness of symptoms such as orthopnea and weight gain enables timely self-management actions, including activity pacing, limb elevation, and medication adjustment. Furthermore, digital health tools and home-monitoring devices play an increasingly important role in supporting patient education, symptom tracking, and sustained self-care in heart failure.