Key result
Nursing interventions combining education and support may improve selected HF self-care dimensions despite heterogeneous effects.
Why the study?
Adequate self-care is vital in heart failure to avoid decompensation, reduce readmissions, and promote quality of life, prompting a synthesis of nursing interventions interpreted through the COM-B model.
Do nursing interventions improve self-care behaviours in adults and older adults with heart failure?
Systematic Review (n=1,162)
Do nursing interventions improve self-care behaviours in adults and older adults with heart failure?
Nursing interventions, particularly those combining education with follow-up and motivational support, can improve heart failure self-care, and their components align well with the COM-B behavioural model.
Supports COM-B-guided nursing programs in HF self-care; extends theory-driven intervention evidence for implementation trials.
Background Heart failure (HF) is a long-term illness, frequently requiring hospital stay and having a significant morbidity and mortality rate. In order to avoid decompensation, lower readmission rates, and promote quality of life, adequate self-care is vital. This review synthesised nursing interventions intended to improve self-care among adults and older adults with HF and retrospectively interpreted their components using the Capability, Opportunity, Motivation–Behaviour (COM-B) model. Method A systematic search was conducted on 11 November 2025 across seven electronic databases: PubMed, Scopus, Web of Science, CINAHL, Embase, MEDLINE, and PsycINFO. The review included randomised controlled studies evaluating behavioural, educational, psychological, or nursing interventions aimed at improving self-care among adults and older adults with HF. Risk of bias was assessed using the Joanna Briggs Institute Checklist for Randomised Controlled Trials. Database-specific search strategies and publication-year filters are reported in Additional file 1. Results Nine studies met the inclusion criteria. The interventions included structured education, motivational interviewing, pre-discharge education, technology-based support, and multimodal programmes. Several studies reported improvements in self-care maintenance, management, or confidence; however, the direction and magnitude of effects varied across interventions and follow-up periods. Although none of the studies explicitly used the COM-B model, their intervention components could be retrospectively mapped to Capability, Opportunity, and Motivation. Conclusions Nursing interventions may improve selected dimensions of HF self-care, particularly when education is combined with follow-up, motivational support, or practical monitoring resources. However, the evidence was heterogeneous, and the magnitude and consistency of effects remain uncertain. COM-B may provide a useful framework for interpreting intervention components, but the retrospective mapping does not demonstrate that COM-B mechanisms were prospectively tested. Systematic review registration The procedure of this study was recently filed in the International Prospective Register of Systematic Reviews (PROSPERO) at the National Institute for Health Research (No: CRD420251237974).
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Kristinawati et al. (2026) conducted a systematic review in Heart failure (n=1,162). Nursing interventions (educational, behavioural, psychosocial) vs. Usual care was evaluated on Heart failure self-care behaviours (measured by SCHFI or EHFScBS). Nursing interventions combining education with follow-up, motivational support, or practical monitoring resources may improve selected dimensions of heart failure self-care, though effects were heterogeneous.
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