Patients’ Experiences of Nurse-Led eHealth Interventions for Chronic Heart Failure: A Qualitative Systematic Review and Meta-synthesis (Preprint)

BACKGROUND Background: Chronic heart failure (CHF) is an increasingly prominent chronic condition in the context of global aging, characterized by high morbidity, rehospitalization, and mortality rates. Self-management ability is widely recognized as a key determinant of improved prognosis and quality of life in CHF patients. In recent years, nurse-led electronic health (eHealth) interventions have been increasingly applied in post-discharge CHF management, showing significant potential in improving treatment adherence and promoting healthy behaviors. However, existing research has primarily focused on objective outcomes, lacking a systematic synthesis of patients’ subjective experiences, thereby limiting the individualization and sustainable implementation of such interventions. OBJECTIVE Objective: This study aimed to conduct a systematic review and meta-synthesis of qualitative research to explore the subjective experiences of CHF patients receiving nurse-led eHealth interventions, identify facilitators and barriers within the intervention process, and enhance the adaptability and patient-centeredness of intervention design. METHODS Methods: This qualitative systematic review and meta-synthesis was conducted in accordance with the Joanna Briggs Institute methodology. Eight databases including PubMed, Web of Science, Embase, Cochrane Library, CINAHL, CNKI, WanFang, and VIP were systematically searched up to July 31, 2025.Grey literature and reference lists of included studies were also manually searched. Eligible studies were appraised for quality and thematically synthesized. RESULTS Results: A total of 20 studies were included, involving 322 CHF patients. Among them, 16 were qualitative studies and 4 were mixed-methods studies. Four overarching themes and 12 subthemes were identified: (1)Patient Empowerment and Enhanced Self-Management;(2)Sense of Security and Continuity of Care Under Professional Support;(3)Variations in Acceptance and Emotional Responses;(4)Barriers and Challenges in Implementing eHealth Interventions. CONCLUSIONS Conclusion: Nurse-led eHealth interventions enhance CHF patients’ self-management abilities and sense of security while extending care beyond the hospital setting. Their effectiveness depends largely on sustained nursing guidance and emotional support, yet remains constrained by patient variability, technological limitations, and resource insufficiencies. Future intervention design should emphasize personalized adaptation and technological refinement to improve accessibility and sustainability, thereby strengthening the clinical utility of remote nursing in chronic disease management.