Purpose
This study examined the relationships of health literacy, physical activity, and grip strength with self-care compliance in older male patients with chronic heart failure.
Methods
A cross-sectional descriptive was conducted, and 106 older male outpatients with chronic HF were recruited from a veterans’ hospital in Seoul. Data were collected from February 7, 2022 to April 10, 2022 using a self-reported questionnaire and were analyzed using SPSS/WIN 23.0.
Results
The average age of the participants was 76.3±4.5 years, and the average time elapsed since the heart failure diagnosis was 3.22±2.01 years. The mean self-care compliance score was 42.21±6.03 out of 60 points. In the univariate analysis, grip strength was not significantly correlated with self-care compliance. The hierarchical regression analysis indicated that health literacy (β=.33, p<.001), physical activity (β=.32, p=.001), and alcohol drinking (β=-.28, p=.001) had statistically significant effects on self-care compliance, collectively explaining 34% of the variance (adjusted R² =.34, F=12.00, p<.001).
Conclusion
The study highlights the necessity of periodically assessing and considering health literacy and the level of physical activity when developing educational strategies to promote self-care compliance among older male patients with heart failure in outpatient nursing practice.

Purpose
Sarcopenia is significantly associated with frailty, readmission, and mortality in patients with heart failure. This review aims to provide an overview of the literature on sarcopenia in individuals with heart failure.
Methods
A comprehensive literature review was conducted regarding the current state of knowledge on assessment tools for the diagnosis, prognosis, and optimal management of sarcopenia in patients with heart failure.
Results
Sarcopenia can be defined as the loss of muscle mass with low muscle strength and/or poor physical performance. Sarcopenia has been officially listed as a disease in the eighth revision of the Korean Classification of Diseases in 2021. The causes of sarcopenia in patients with heart failure are multifactorial, including chronic inflammation, hormonal imbalances, nutritional deficiencies, low muscle blood flow, and endothelial dysfunction. The management of sarcopenia is primarily focused on exercise and/or nutritional management because there is no specific pharmacological therapy to treat sarcopenia.
Conclusion
Healthcare professionals should be aware of the significance of early detection and timely management of sarcopenia to avoid physical disability, long-term institutional care, and mortality in individuals with heart failure. Clinical trials are required to evaluate the effectiveness of interventions including exercise and nutrition, alone or in combination, on sarcopenia in patients with heart failure. In addition, more research is required to identify multidimensional risk factors and diagnostic biomarkers for sarcopenia.

Purpose
This study aims to explore the relationship between the discharge process and two-year prognosis in patients with Heart Failure (HF) who were hospitalized because of HF exacerbation. Methods Medical records were reviewed to identify patients admitted for HF exacerbation. Information regarding the following discharge processes was collected: follow-up visits, discharge educational contents, and the presence of family caregivers during patient education. HF-related events, including emergency department visits, readmissions, or death because of HF, were defined as a composite of events. A multivariate Cox proportional hazards regression model was used after adjusting for covariates to explore the association between the discharge process and HF-related events. Results A total of 201 patients were included in this study. In the two-year follow-up periods, 41 patients (20.4%) experienced at least one HF-related event. Follow-up visits were scheduled at an average of 8.11±2.92 days after discharge. Approximately 95.0% of the patients received discharge education with an average of 1.66±1.04 topics, and 69.7% of the families participated in this educational activity. In the multivariate Cox regression model, not having family members during education was associated with a longer time to HF-related events (hazard ratio: 2.09; 95% confidence interval: 1.001~4.346). However, follow-up visits and the amount of educational content received were not associated with time to HF-related events. Conclusion The presence of family caregivers during education appears to be a protective factor against adverse prognosis in patients with HF. Our results highlight the importance of family engagement during discharg

Citations

• Depression, mutuality, and self-care behaviors in patients with heart failure and their caregivers: An actor–partner interdependence model extended to mediation
  Youn-Jung Son, JiYeon Choi, Da-Young Kim, So Hyun Park
  Heart & Lung.2025; 73: 123.     CrossRef
• Association Between Nurse-Led Multidisciplinary Education and Cardiac Events in Patients With Heart Failure: A Retrospective Chart Review
  Haeng-Mi Son, Hyeongsuk Lee
  Asian Nursing Research.2024; 18(1): 60.     CrossRef

Purpose
Patients with heart failure report low levels of physical activity and quality of life, both of which are important predictors of patient prognosis. This study aimed to investigate the effects of nurse-led motivational interviewing on self-efficacy for exercise, engagement in regular exercise, exercise capacity, and quality of life among patients with heart failure.
Methods
A randomized controlled trial design was used, and 66 Korean participants (i.e., 38 in a control group and 28 in an intervention group) aged 40~80 years who were diagnosed with heart failure were recruited between May 2012 and September 2013. The intervention group received telephone-based motivational interviews twice a week for one month. All participants were assessed for exercise regularity, levels of exercise, exercise capacity, and quality of life at baseline, one month, and three months. The data were analyzed using independent t-tests, repeated measures ANOVA, and nonparametric tests.
Results
At one month, there were significant group differences in exercise regularity (x² =6.10, p=.013) and levels of exercise (Z=-2.56, p=.024). There was a significant group-by-time effect on the quality of life (F=3.76, p=.044).
Conclusion
Nurse-led motivational interviewing was effective in increasing exercise levels and quality of life in patients with heart failure. In the future, we propose a study with a larger number of participants and a long-term follow-up study with additional contact to maintain the intervention effect.

Citations

• Empowering Trusted Messengers With Motivational Interviewing Skills: Improving Dissemination of Accurate Information to Communities
  Marie Ivantechenko, Shubarna Akhter, Damara Gutnick
  Community Health Equity Research & Policy.2024;[Epub]     CrossRef
• Effectiveness of behavioural interventions with motivational interviewing on physical activity outcomes in adults: systematic review and meta-analysis
  SuFen Zhu, Deepra Sinha, Megan Kirk, Moscho Michalopoulou, Anisa Hajizadeh, Gina Wren, Paul Doody, Lucy Mackillop, Ralph Smith, Susan A Jebb, Nerys M Astbury
  BMJ.2024; : e078713.     CrossRef
• Benefits and Harms of Digital Health Interventions Promoting Physical Activity in People With Chronic Conditions: Systematic Review and Meta-Analysis
  Graziella Zangger, Alessio Bricca, Behnam Liaghat, Carsten B Juhl, Sofie Rath Mortensen, Rune Martens Andersen, Camma Damsted, Trine Grønbek Hamborg, Mathias Ried-Larsen, Lars Hermann Tang, Lau Caspar Thygesen, Søren T Skou
  Journal of Medical Internet Research.2023; 25: e46439.     CrossRef

Purpose
The purpose of this study was to construct and test a hypothetical model of exercise behavior in patients with Heart Failure (HF) based on the Information-Motivation-Behavioral skills (IMB) model, and the IMB model including depression (IMBD). Methods: Data collection was conducted from February 1 to March 15, 2019. A total of 306 patients who were diagnosed with HF and were receiving outpatient treatment at the D University hospital and S hospital located in B city were included in the final analysis. The collected data were analyzed using SPSS 24.0 and AMOS 25.0 program. Results: The IMB model (x² /df=2.45, SRMR=.07, RMSEA=.07, GFI=.98, AGFI=.94, TLI=.93, CFI=.97) and IMBD model (x² /df=0.79, SRMR=.02, RMSEA=.003, GFI=.99, AGFI=.97, TLI=.98, CFI=.97) were a good fit for the data. In the exercise behavior IMB model, exercise behavior was explained by 55.1% by information, personal motivation, and behavioral skills. In the exercise behavior IMBD model, exercise behavior was explained by 60.4% by information, personal motivation, behavioral skills, and depression. Conclusion: The IMBD model showed high predictive power of exercise behavior. Therefore, in order to improve HF patients’ exercise behavior, it is necessary to identify and manage patients who experience depression. The development and application of integrated interventions to provide appropriate information, motivation, and confidence in exercise can be an effective strategy in increasing exercise compliance, and ultimately contribute to improving the health outcomes of patients with HF.

Citations

• Exercise and adults with hemophilia: a systematic review and meta-analysis
  Doo Young Kim, Mi Yang Jeon, Young Eun, Da In Jeong
  Journal of Korean Biological Nursing Science.2024; 26(1): 1.     CrossRef
• Factors Affecting Health-promoting Behavior of Nurses in Small and Medium-sized Hospitals based on the IMB Model
  Jin Hee Jeong, Hye Kyung Lee
  The Korean Journal of Rehabilitation Nursing.2022; 25(2): 102.     CrossRef
• Factors Influencing Performance of Exercise Behavior of Middle-Aged Men with Chronic Disease Based on the Information–Motivation–Behavioral Skill-Revealed-Related Variables (IMBR) Model
  Hee-Kyung Kim, Hyoungtae Kim, Jeong-Hyo Seo
  Healthcare.2022; 11(1): 100.     CrossRef

Purpose
The aim of this study was to identify the knowledge structure of nursing research on heart failure in Korea.
Methods
Fifty-two studies published in Korea and 41 published abroad by domestic researches from 1988 to 2019, were included. Meaningful morphemes from the abstracts were extracted and refined, and co-occurrence matrix was generated. Using Phython 3.7 for edge weight, degree centrality, closeness centrality, and betweenness centrality and Gephi 0.9.2 for visualization, 571 keywords were analyzed.
Results
The core keywords were “patient”, “heart failure”, “symptom”, “function”, “quality of life”, “self-care”, and “intervention”. The sociogram identified “patient”, “heart failure”, and “symptom” as the largest node, and the edge weight between the keywords was the highest. From 1988 to 2019, keywords such as “patient”, “heart failure”, and “symptom” ranked the highest. Especially, from 2016 to 2019, “quality of life”, “NYHA”, and “medication” ranked lower, but “cognition”, “health literacy”, “behavior”, “self-efficacy”, “man”, “woman”, and “age” newly appeared or ranked higher.
Conclusion
It is recommended that Korean heart failure nursing researchers conduct researches related to self-care for symptom management of heart failure patients, especially on nursing interventions. In addition, nursing researchers should conduct studies on the cognition and health literacy related to self-care of the elderly patients with heart failure

Citations

• Images of Nurses Appeared in Media Reports Before and After Outbreak of COVID-19: Text Network Analysis and Topic Modeling
  Min Young Park, Seok Hee Jeong, Hee Sun Kim, Eun Jee Lee
  Journal of Korean Academy of Nursing.2022; 52(3): 291.     CrossRef

PURPOSE
The objective of this study was to identify factors related to self-care adherence in symptomatic patients with heart failure (HF).
METHODS
Using a cross-sectional design, a convenience sample 209 outpatient clinic patients were recruited at two medical centers. Between October 2011 and August 2012, data were collected using the structured questionnaire. Factors related to self-care adherence were examined using hierarchical multiple regression.
RESULTS
Mean age of participants was 67.71 years and a half of them (53.6%) were female. They showed relatively low self-care adherence with mean scores of 61.88±12.92. Lower self-care adherence was reported in asking for low sodium items, weighing oneself, checking for ankle edema, and exercising for 30 minutes. The overall model significantly explained 23.9% of variance in self-care adherence. Among the predictors, education, New York Heart Association functional classification, and social support were statistically significant in influencing self-care adherence. The variable of negative emotional status such as anxiety and depression were not found to be significant.
CONCLUSION
These findings demonstrate that social support could help self-care adherence among symptomatic patients with HF. Thus, programs targeting self-care adherence in this population should consider the strategies improving social support.

Citations

• An Integrated Literature Review on Cardiac Rehabilitation Program for Patients with Coronary Artery Disease
  Hong-A Lim, Yeoungsuk Song
  Journal of Health Informatics and Statistics.2024; 49(3): 205.     CrossRef
• Self-care model based on the theory of unpleasant symptoms in patients with heart failure
  In-Suk Yang, Younhee Kang
  Applied Nursing Research.2018; 43: 10.     CrossRef

PURPOSE
The purpose of this study was to identify the effects of reinforced walking exercise on dyspnea-fatigue symptoms, daily activities, walking ability and health related quality of life (HRQoL) in heart failure patients.
METHODS
This study used a randomized controlled trial design. The participants (experimental group=16, control group=25) were recruited from a university hospital in Kyeong-nam area. Data were collected from March to September, 2015. The reinforced walking exercise included goal setting and feedback (telephone and text message) provided for 12 weeks. Dyspnea-Fatigue Index, Korean Activity Scale/Index (KASI), six-minute walking distance (6MWD) and HRQoL were measured. Data were analyzed using descriptive statistics, t-test, Fisher's exact test, χ2 test, and Kolmogrove-Smirnov test.
RESULTS
Prior to the intervention there were no differences in the research variables between two groups. The exercise compliance in the experimental group was 100% (walking for 50 minutes per day, 5 times per week). The experimental group had improved dyspnea-fatigue symptoms (t=8.63, p<.001), daily activities (t=-4.92, p<.001), longer 6MWD (t=-5.66, p<.001), and increased HRQoL (t=-9.05, p<.001) compared to the control group.
CONCLUSION
The reinforced walking exercise could be a cost-effective intervention in heart failure patient, which could enhance patients' outcomes, such as improving dyspnea-fatigue symptoms, daily activities, walking ability, and quality of life.

Citations

• A Case Report on the Improvement of Dyspnea and Edema Caused by Heart Failure Through a Complex Korean Medicine Treatment
  Jumin Kim, Hyeryun Lee, Hyungsun Jun, Dasol Park, Jungtae Leem
  The Journal of Internal Korean Medicine.2025; 46(1): 172.     CrossRef
• Exercise-based cardiac rehabilitation for adults with heart failure
  Cal Molloy, Linda Long, Ify R Mordi, Charlene Bridges, Viral A Sagar, Edward J Davies, Andrew JS Coats, Hasnain Dalal, Karen Rees, Sally J Singh, Rod S Taylor
  Cochrane Database of Systematic Reviews.2024;[Epub]     CrossRef
• Home-based versus centre-based cardiac rehabilitation
  Sinead TJ McDonagh, Hasnain Dalal, Sarah Moore, Christopher E Clark, Sarah G Dean, Kate Jolly, Aynsley Cowie, Jannat Afzal, Rod S Taylor
  Cochrane Database of Systematic Reviews.2023;[Epub]     CrossRef
• The Effects of Exercise-Based Interventions on Fluid Overload Symptoms in Patients with Heart Failure: A Systematic Review and Meta-Analysis
  Mei Rosemary Fu, Yuan Li, Catherine Conway, Alessandra Masone, Jinbo Fang, Christopher Lee
  Biomedicines.2022; 10(5): 1111.     CrossRef
• Effects of Smartphone-Based Compensatory Cognitive Training and Physical Activity on Cognition, Depression, and Self-Esteem in Women with Subjective Cognitive Decline
  Yanghee Pang, Oksoo Kim
  Brain Sciences.2021; 11(8): 1029.     CrossRef

PURPOSE
To evaluate heart failure knowledge and adherence to self-care behaviors, and to identify factors affecting adherence to self-care behaviors among Korean patients with heart failure.
METHODS
Correlational research using the European Heart Failure Self-care Behavior Scale, the Duke Activity Status Index, the Dutch Heart Failure Knowledge Scale, the New York Heart Association Functional Classification, and the Medical Outcomes Study Social Support Survey was conducted. A total of 280 outpatients with heart failure responded to the five questionnaires.
RESULTS
The mean scores for self-care adherence and heart failure knowledge were 31.98 +/- 6.81 and 8.78 +/- 2.53, respectively, indicating lower adherence and knowledge than those previously reported. Subjects with lower functional status, more social supports, and greater knowledge of heart failure are more likely to adhere to prescribed regimens.
CONCLUSION
Nurses should focus on patient education and support to improve their adherence to self-care behaviors.

Citations

• Levels of adherence to treatment, illness perception and acceptance of illness in patients with coronary artery disease - descriptive and correlational study
  Farzad Dugunchi, Shiv Kumar Mudgal, Zohreh Hosseini Marznaki, Hoda Shirafkan, Saeed Abrotan, Fateme Jafarian, Roghayeh Pourkia
  BMC Cardiovascular Disorders.2024;[Epub]     CrossRef
• Self-care behavior and associated factors among adult heart failure patients in outpatient cardiac follow-up unit at Wachemo University Nigist Eleni Comprehensive Specialized Hospital, Southern Ethiopia
  Ermias Sigebo Sugebo, Teshager Worku Kassie, Tesfaye Gobena, Temesgen Kechine Tibore, Sisay Foga Sebro, Tadesse Lelago Ermolo
  BMC Cardiovascular Disorders.2024;[Epub]     CrossRef
• Individual and systems-related factors associated with heart failure self-care: a systematic review
  Carolyn Kleman, Stephanie Turrise, Heidi Winslow, Omar Alzaghari, Barbara J. Lutz
  BMC Nursing.2024;[Epub]     CrossRef
• Adherence to self-care practices and associated factors among heart failure patients in Ethiopia: A systematic review and meta-analysis
  Firomsa Bekele, Lalise Tafese, Addisalem Workie Demsash, Hana Tesfaye, Busha Gamachu Labata, Ginenus Fekadu, Mohammed Feyisso Shaka
  PLOS ONE.2023; 18(8): e0288824.     CrossRef
• Self-Care and Quality of Life Among Adult Patients With Heart Failure: Scoping Review
  Sheka Shemsi Seid, José Amendoeira, Maria Regina Ferreira
  SAGE Open Nursing.2023;[Epub]     CrossRef
• Psychosocial Interventions to Enhance Treatment Adherence to Lifestyle Changes in Cardiovascular Disease: A Review of the Literature 2011-2021
  Aspasia Pizga, Eleftherios Karatzanos, Stamatoula Tsikrika, Vassiliki Gioni, Ioannis Vasileiadis, Serafim Nanas, Panagiotis Kordoutis
  European Journal of Environment and Public Health.2022; 6(1): em0102.     CrossRef
• Validity and Reliability of the Korean Version of the Revised Self-Care of Heart Failure Index v7.2
  JinShil Kim, Kye Hun Kim, Young-Hyo Lim, Seongkum Heo, Keumyi Moon, Mi Sook Oh, Minjeong An
  Clinical Nursing Research.2022; 31(7): 1296.     CrossRef
• The Relationship Between Body Awareness and Self-care in Patients With Heart Failure
  Kyoung Suk Lee, Jin-Oh Choi, Eun-Seok Jeon, Jae-Hyeong Park, Mi Sook Jung
  Journal of Cardiovascular Nursing.2022; 37(3): 266.     CrossRef
• Adherence to Self-Care Recommendations and Associated Factors among Adult Heart Failure Patients in West Gojjam Zone Public Hospitals, Northwest Ethiopia
  Belayneh Molla, Haimanot Abebe Geletie, Girma Alem, Tenaw Gualu, Bitew Tefera Zewudie, Shegaw Tesfa, Tadesse Tsehay, Baye Tsegaye Amlak, Khoa Nguyen
  International Journal of Chronic Diseases.2022; 2022: 1.     CrossRef
• Developing a Middle-Range Theory of Heart Failure Self-Care
  Sumayya A. Attaallah, Rosalind M. Peters, Ramona Benkert, Hossein Yarandi, Sandra Oliver-McNeil, Faith Hopp
  Nursing Science Quarterly.2021; 34(2): 168.     CrossRef
• Self-Care Behavior and Associated Factors among Heart Failure Patients in Tigray, Ethiopia: A Cross-Sectional Study
  Tsegu Hailu Gebru, Kalayou Kidanu Berhe, Weyzer Tilahun Tsehaye, Haftea Hagos Mekonen, Kbrom Gemechu Kiros, Tesfay Gebreslassie Gebrehiwot, Gessessew Teklebrhan Gebrehiwot, Yared Hailesilassie Teka, Hayat Maeruf Mohammed
  Clinical Nursing Research.2021; 30(5): 636.     CrossRef
• Knowledge, Adherence to Lifestyle Recommendations, and Quality of Life Among Koreans With Heart Failure
  Haejung Lee, Gaeun Park, Kyoung Suk Lee, HyeKyung Jin, Kook-Jin Chun, Jong Hyun Kim
  Journal of Cardiovascular Pharmacology and Therapeutics.2020; 25(4): 324.     CrossRef
• Adherence to self-care recommendations and associated factors among adult heart failure patients. From the patients’ point of view
  Mohammed Assen Seid, Ousman Abubeker Abdela, Ejigu Gebeye Zeleke, Amir H. Pakpour
  PLOS ONE.2019; 14(2): e0211768.     CrossRef
• Distinct Factors Associated With Better Self-care in Heart Failure Patients With and Without Mild Cognitive Impairment
  Kyoung Suk Lee, Jin-Oh Choi, Eun-Seok Jeon, Jae-Hyeong Park, Mi Sook Jung, Zian Lee, Hyeong Suk Lee, Hye Jin Yoo
  Journal of Cardiovascular Nursing.2019; 34(6): 440.     CrossRef
• Factors related to self-care behaviours in heart failure: A systematic review of European Heart Failure Self-Care Behaviour Scale studies
  Natasa Sedlar, Mitja Lainscak, Jan Mårtensson, Anna Strömberg, Tiny Jaarsma, Jerneja Farkas
  European Journal of Cardiovascular Nursing.2017; 16(4): 272.     CrossRef

PURPOSE
This study was conducted to examine the effects of tailored supportive education on physical, psychological status and quality of life in the patients with congestive heart failure (CHF) who had not participated previously in cardiac rehabilitation program.
METHODS
This study was used a non-equivalent control pre-post design, conducted on 64 CHF patients under medical treatment in a hospital. The experimental group (n=31) received the tailored supportive educational program (once 1~2 days before discharge and 6 times after discharge through outpatient visits or telephone contact: once every week for the first 4 weeks after discharge and once every 2 weeks for the remaining 4 weeks). The control group (n=33) received a traditional discharge education. Data were analyzed using descriptive statistics, chi2-test, Fisher's exact test, t-test and repeated measure ANOVA using the SPSS/WIN 18.0 program.
RESULTS
Participants in the experimental group showed the significantly increased scores of the quality of life (F=16.01, p<.001), and the significantly decreased scores of physical function (F=7.27, p=.009), depression (F=8.25, p=.006) and anxiety (F=4.11, p=.047), when compared to those of the control group.
CONCLUSION
The findings indicated tailored supportive education was an effective intervention care in physical, emotional status and quality of life for CHF patients.

Citations

• Needs for Discharge Education of Family Caregivers of Pediatric Patients: An Integrative Review
  Hyunjie Lee, Seung Eun Lee, Sang Hwa Lee
  Journal of Korean Academy of Fundamentals of Nursing.2023; 30(2): 137.     CrossRef
• Knowledge Structure of Nursing Studies on Heart Failure Patients in South Korea through Text Network Analysis
  Seang Ryu, Hyunyoung Park, Yun-Hee Kim
  Korean Journal of Adult Nursing.2020; 32(4): 409.     CrossRef
• The Effect of a Telephone-Based Self-management Program Led by Nurses on Self-care Behavior, Biological Index for Cardiac Function, and Depression in Ambulatory Heart Failure Patients
  Mi Kyoung Moon, JongEun Yim, Mi Yang Jeon
  Asian Nursing Research.2018; 12(4): 251.     CrossRef
• The Effects of Reinforced Walking Exercise on Dyspnea-fatigue Symptoms, Daily Activities, Walking Ability, and Health related Quality of Life in Heart Failure Patients
  Hyekyung Jin, Haejung Lee
  Korean Journal of Adult Nursing.2016; 28(3): 266.     CrossRef
• Development and Effects of a Heart Health Diary for Self-Care Enhancement of Patients with Heart Failure
  Jae Lan Shim, Seon Young Hwang
  Journal of Korean Academy of Nursing.2016; 46(6): 881.     CrossRef
• Influence of Social Support and Negative Emotional Status on Self-care Adherence in Symptomatic Patients with Heart Failure
  In-Suk Yang
  Korean Journal of Adult Nursing.2016; 28(3): 302.     CrossRef
• Symptom Management to Predict Quality of Life in Patients with Heart Failure: A Structural Equation Modeling Approach
  Ja Ok Lee, Rhayun Song
  Journal of Korean Academy of Nursing.2015; 45(6): 846.     CrossRef

PURPOSE
The purpose of this study was to test a hypothetical model of health-related quality of life in patients with heart failure. The hypothetical model was derived from the Wilson and Cleary's model, the Rector's model, and published research findings.
METHODS
Data from 103 patients with heart failure were analyzed to determine the best multivariate health-related quality of life model given variables derived from the prior studies. The statistics programs SPSS 12.0 and LISREL 8.7 program were used for descriptive statistics and covariance structure analysis respectively.
RESULTS
The overall fitness of the path final model was good(GFI=.97, AGFI=.95, NNFI=1.06, NFI=.96, p=.96). Symptoms were directly affected by gender. HYHA Class was directly affected by only gender. Physical functioning limitation was directly affected by exercise. Health perception was directly affected by economics, symptom, and physical functioning limitation. Depression was directly affected by exercise and health perception. Heath-related quality of life was directly affected by physical functioning limitation and depression, indirectly affected by gender, economics, exercise, symptoms, NYHA Class, and health perception. This path analysis model explained 51% of health-related quality of life in patients with heart failure.
CONCLUSION
To improve of health-related quality of life with heart failure patients, it is necessary to make nursing interventions for physical functioning and depression.

PURPOSE
The purpose of this study was to identify effects of a self-management program on symptom and functional status, health perception, and quality of life(QOL) of patients with CHF.
METHODS
Patients with CHF as defined through clinical judgment using the Framingham criteria and EF<50% were enrolled in the study (experimental: 21, control: 20). The symptom focused self-management program consisted of coping behaviors for symptoms including dyspnea, chest discomfort/pain, dizziness, ankle edema, and basic self-management including medications, diets, activity, lifestyle changes. Experimental group received an educational booklet after survey, and periodic telephone follow-up by a trained nurse. Data were collected the 3rd day after admission and at 1 month, 3 months, and 6 months after discharge using questionnaires.
RESULTS
Significant differences were found in the presence of symptoms, health perception, and QOL between groups during follow-up. Although no significant difference was found in functional status, the experimental group reported better functional status than the control group.
CONCLUSION
By facilitating self-management of CHF using tailored interventions including education programs and telephone monitoring, it is expected that patients will be able to monitor their symptoms routinely, adhere to therapeutic regimen, and have a better QOL.

PURPOSE
The main purpose of this study was to examine the effectiveness of a standardized telephone monitoring intervention in addressing the symptom experience and improving self-management ability in patients with heart failure. METHODS: A non-equivalent control group pre-post test design was used. There were 17 patients in the experimental group, and 16 in the control group. According to the protocol, patients in the experimental group received 15 to 30 minute-telephone monitoring four times, once a week for 4 weeks. Data were analyzed by chi2-test, Mann-Whitney U test. RESULTS: 1) The experimental group showed a significant increase in compliance with self-management compared to the control group. 2) There was a significant decrease in degree for 3 symptoms(DOE, PND, & continuing fatigue) in the experimental group, after telephone monitoring. However, the experimental group did not show significant decrease in the degree of the total symptom experiences. CONCLUSIONS: The results of this study provide evidence that standardized telephone monitoring is effective in relieving symptom experience and improving self- management in patients with heart failure over the course of telephone monitoring.

PURPOSE
The purpose of this study was to identify effects of a self-management program on self-efficacy and compliance in patients with CHF. Hypothesis: 1) Patients with CHF who are provided with a self-management program will show higher self-efficacy scores than a control group. 2) Patients who are provided with a self-management program will show higher compliance scores than a control group. METHOD: This study was designed as a nonequivalent non-synchronized pre-posttest control group. There were eight patients in the experimental group, and twelve in the control group. According to NYHA classification, all patients belonged under the classesl to lV. Data were collected using the instruments developed by the researchers. Data were analyzed using descriptive statistics and Mann Whitney U test. RESULT: There were significant differences in self-efficacy scores and compliance scores between the experimental and control group. CONCLUSION: By utilizing the program, patients were able to monitor their symptoms routinely, comply with therapeutic regimen, and feel better able to positively influence their disease. Therefore, better compliance means fewer readmissions of patients with CHF.