Table 1 Studies included in the review

Auld et al., 2018 [22] (USA)

Secondary analysis from longitudinal study

None

Not stated

Community-based outpatient HF clinic associated with academic medical university

146

57 (13.5) No range

70%

None

HFSPS dyspnea, edema; ESS; SCHFI v.6; PHQ9; BSI-anxiety

latent class mixture analysis (LCMA); Latent growth modeling; multivariate backwards stepwise logistic regression

Bidwell et al., 2015 [23] (Italy)

Secondary analysis; cross sectional

Situation specific theory of HF self-care

Not stated

Ambulatory Cardiovascular clinics

364 Dyads

Patient 76.26 (10.7)

Caregiver 57.44 (14.6)

No range

Patient 57%

Informal Caregivers 48%

None

Caregiver-QOL- SF-12; MLHFQ; MMSE; CBI; COPE Index; SCHFI v.6

multilevel modeling; dyadic cross-sectional multivariate outcomes models

Buck et al., 2015 [24] (Italy)

Secondary analysis of cross-sectional database; Self-created model testing

Situation specific theory of HF self-care

Not stated

Cardiovascular centers

628

72.98 (11)

No range

57.60%

None

CCI; SCHFI V6.2; MLHFQ

SEM; interaction levels

Bugajski et al., 2021 [25] (Italy)

Secondary Analysis

Situation specific theory of HF self-care

Convenience

Outpatient setting

277 Dyads

Patient: 75.5 (10.8)

Caregiver: 52.8 (15)

No range

Patient 54.9% Caregiver 29.6%

None

SCHFI 7.2, CC-SCHFI v.2, Dyadic Symptom Management Type (DSMT)

Multilevel Modeling

Cao et al., 2016 [26] (China)

Cross sectional

Situation specific theory of HF self-care

Not stated

In-patient medical wards

127

64.9 (12.34)

No range

61.40%

None

SCHFI v.6; DS-14

Multiple linear regression

Cavalcante et al., 2018 [27] (Brazail)

Cross sectional

None

Not stated

In-patient

57

Range 43–95, No mean

57.90%

None

EAAPIC

Student's t-test Mann–Whitney U test

Cené et al., 2015 [28] (USA, North Carolina)

Observational, cross sectional Carolina Data Warehouse for Health (CDW-H) used for eligibility

None

Not stated

Outpatient clinics

150

61 (12)

Range 22–84

49%

Black

66 (45%)

SCHFI v.6.2; CES-D; 10-item measure; Blessed test of Orientation-Memory Concentration; Family APGAR

regression analyses with mediation analysis

Chang, et al., 2017 [29]

Northern Taiwan

Cross-sectional study

Situation-specific theory of HF

Convenience

Cardiology outpatient clinic

201

62.40 (11.40)

No range

69.7%

None

Chinese version SCHFI v. 6.2; Chinese version BDI-II; Chinese version CRS

Moderated mediation model

Choi et al., 2019 [30] (USA, California)

Correlational, cross sectional

Situation-specific theory of HF

Not stated

Cardiomyopathy Center

21

53.8 (7.9)

No range

71.4%

None

Demographic data, clinical data from medical record, MoCA, TMT-B, SCHFIv6, MRI

Statistical parametric mapping package, DTI Toolkit, MRIcroN, MATLAB based custom software for images, descriptive statistics, partial correlations using SPSS

Chuang, et al., 2019 [31]

(Taiwan)

Cross-sectional study

Situation specific theory of HF

(mentioned)

Not stated

Cardiology outpatient clinic

141

65.2 (11.9)

Range 26–83

55.3%

None

Chinese version of: PHQ-9; MSPSS; eHealth Literacy Scale; DHFKS; SCHFI v. 6.2

Path analysis

da Conceição et al., 2015 [32]

(Brazil)

Descriptive Cross-sectional

a naturalistic decision-making model

Non-probabilistic

Ambulatory care setting

116

57.7 (11.3)

Range 20–81

54.30%

White: 69 (59%)

Black: 31 (26%)

Brown 16 (13.8%)

Brazilian version SCHFI- v 6.2; MMSE; CCI; type of monitoring received by the patient (if supervised exclusively by the physician or by physician and nurse)

ANCOVA model

Davis et al., 2015 [33]

(USA)

Secondary analysis, descriptive correlational

naturalistic decision-making process, mentioned

Not stated

In-patient

125

59 (13)

Range 22–98

53%

White: 39 (31%)

Black: 84 (67%)

Other: 2 (2%)

MoCA was SCHFI; DHFKS; GDS; ENRICHD Social Support Inventory; The Charlson Comorbidity Index

Multiple linear regression

Dellafiore et al., 2018 [34]

(Italy)

Cross-sectional

none

Convenience sampling

Clinic in a hospital

346

65.6 (13.6)

No range

74%

Italian (100%)

SCHFI v..6.2

Logistic regression (LR) models

Dickson et al., 2015 [35]

(USA)

Secondary analysis of existing data collected for a prospective cohort study

none

Not stated

Clinics, HF clinic, VA facility

272

 > 60 = 53.1% < 60 = 46.9%

No range, no mean

62.50%

White: 17(64.7%)

Black: 96(35.3%)

MSPSS; SCHFI v.6.2. NART; DHFKS

Adaptive logistic regression. Fisher Exact t-test

Fivecoat et al., 2018 [36]

(USA)

Secondary analysis of data from a prospective cohort study

NA

Not stated

Three sites but did not specify

280

61.99(12.47) Range 24–89

64.30%

None

SCHFI v. 6.2

Multilevel modeling, using the SAS PROC MIXED procedure

Freedland et al.,

2021 [37]

(USA)

Part of a larger study-

Not stated

Situation Specific

Not stated

Hospital inpatient

400

58.4 (13)

No range

49.5%

49% white

Depression Interview and Structured Hamilton, PHQ-9, SCHFI v.6, Generalized Anxiety Disorder questionnaire, Perceived Stress Scale, Enhancing Recovery in Coronary Heart Disease Social Support Instrument, Kansas City Cardiomyopathy Questionnaire, Duke Activity Status Index

Multi- level modeling

Gebru et al.,

2020 [38]

(Ethiopia)

Cross-Sectional

None specified

Systematic Random Sampling Technique

Cardiac clinic outpatient clinics

408

45.4 (19)

No range

45.1%

None (ethnicity measured)

EHFSCBS, DHKS, MSPSS

Multivariable logistic regression analysis

Graven et al., 2015 [39]

(USA) Symptomatology and coping resources predict self-care behaviors

Cross-sectional, correlational predictive

Theory of Stress and Coping

Not stated

Hospital-affiliated outpatient offices in North Florida

201

72.6(8.9)

No range

62.70%

Nonminority: 173 (86.1%)

Minority: 28 (13.9%)

EHFScBS-9; SPSIR-S; HFSS, Graven and Grant Social Network Survey

Multiple linear regression with true stepwise variable selection was used

Graven et al., 2015 [40]

(USA)

Predicting depressive symptoms of patients with HF

Cross-sectional descriptive correlational

Stress, Appraisal and Coping Theory

Convenience sampling

Outpatients with HF 3 hospital-affiliated outpatient clinics in Northwest Florida

201

72.57(8.94)

Range 55–99

62.60%

White: 173(86.1%)

Black: 27(13%)

Latino/Hispanic: 1 (5%)

EHFScBS-9; SPSIR-S; HFSS

SEM

Graven et al., 2021 [41]

(USA)

Descriptive, cross-sectional, correlational study, secondary analysis

None stated

Not stated

Two acute care facilities

107

61(13.9)

No range

54.20%

Non Caucasians: 56%

SCHFI

Multiple linear regression

Heo & Kim,

2020 [42]

(Korea)

Cross sectional descriptive

Noe stated

Not stated

Cardiology outpatient clinic

90

72.61 (11.88)

No range

36.7%

None

Cardiovascular Disease Resilience Scale CDR, EHFSCB Type D Personality Scale 14

Correlation, hierarchical multiple regression

Heo et al., 2021 [43] (USA)

Cross sectional correlational

None listed

Not stated

HF clinics or hospital units

94

53.6-and 60.3

Two groups of participants, Adherents and non-adherents

No range

44%

55% Caucasian

Medication Event Monitoring System, 24 h urine, SCHFI SC management scale, PHQ-9, Control Attitudes Scale-Revised, MSPSS

Logistic regression, Odds ratio, chi square

Hjelm et al., 2015 [44]

(Sweden)

Cross sectional

None stated

Not stated

Outpatient clinics at one university hospital and two county hospitals in the south of Sweden

105

Median 72 (65–79)

68%

None

PHQ-9;EHFScBS-9; Word Knowledge test, Neuropsychological test battery, Mini mental state examination, Trail making test

Multiple linear regression

Jo et al.,

2020 [45]

(South Korea)

Cross sectional-descriptive

None reported

Not stated

Cardiac outpatient clinic

252

73.65(8.08)

No range

50.4%

None

BHLS; ESSI (ENRICHD social Support Instrument); EHFScBS-9

Hierarchical regression

Kazeminezhad et al.,

2020 [46]

(Iran)

Descriptive-analytical

None reported

Not stated

Inpatient

400

Not reported

45.5%

None

Praying Questionnaire

Questionnaire of Self-Care behaviors in HF

ANOVA and regression analysis

Kessing et al., 2016 [47]

(Netherlands)

Secondary data analysis of longitudinal, baseline 12 and 18 months

None listed

Not stated

Outpatients

545

66.2 (9.6)

No range

75%

None

EHFScB-9; FAS; DEFS; HCS; SAD4

SEM

Lee et al., 2017 [48]

(USA) Living Arrangements

Secondary analysis of cross-sectional data collected

None listed

Not stated

Ambulatory HF clinics

206

60(11.6) Range 32–87

67%

White: 159 (77.2%)

Minority: 47 (22.8%)

SCHFI; PHQ-9; NYHA

Chi Square testing, Spearman correlation coefficient

Lee et al., 2017 [49] (USA) Self-care in rural residents

Secondary Analysis

None listed

Not stated

Rural clinics

508

66 (13)

Range 23–96

58.80%

Caucasian: 514 (89%)

EHFScB-9; S-TOFHLA; PHQ-9;. BSI; CAS-R; MLHFQ; Mini-Cog.; NYHA; CCI

Multivariable linear regression

Lee et al., 2019 [50]

(Korea)

Cross-sectional, observational

Situation Specific theory of HF self-care

Not stated

Outpatient clinics

132

60(12.8) Range 25–85

72%

None

DHFKS, CAS-R, NYHA, CCI, Seoul Neuropsychological Screening Battery II, Stroop Color/Word Interference Test, backward digit span, and Controlled Oral Word Association Test letter fluency. MOS social support survey

Chi-square test, independent t test, stepwise regression,

Liu et al., 2018 [51]

(China)

Secondary analysis. Cross sectional

Mediation conceptual models

Not stated

Cardiac wards in Chinese hospitals

127

64.9(12.34)

No range

61.40%

None

SCHFI v 6.2; DS-14D; NYHA

Mediation analysis

Lyons et al., 2017 [52]

(USA)

Cross sectional

None listed

Convenience

HF Clinic Pacific Northwest

60 Couples

Patients 59.45 (11.92)

Spouses 57.75(11.91)

No range

66%

Non-Hispanic White:

Patient 88.3%

Spouse 86.7%

NYHA; SCHFI v. 6.2; EHFScBS-9;

Multilevel modeling

Massouh et al., 2020a [53]

(Lebanon)

Determinants

Cross-sectional correlational

Self-care in chronic illness theory

Consecutive

Inpatient units and outpatient units at a tertiary medical center

*100

(51 respondents to Self-Care Management scale)

67.59 (12.09)

No range

76%

None

SCHFI (Arabic version), NYHA, CCI, PHQ-9, ESSI, DHFKS

Descriptive statistics, independent t test, ANOVA or Pearson R, regression

Massouh et al.,

2020b [54]

(Lebanon)

Self-care confidence

Cross-sectional, correlational

None noted

Consecutive

Inpatient units and outpatient units at a tertiary medical center

100

67.59 (12.09)

No range

76%

None

SCHFI (Arabic version), ESSI, DHFKS

Descriptive statistics, independent t-test, ANOVA or Pearson r, mediation analysis,

Masterson-Creber et al. 2017 [55]

(USA)

Prospective cross-sectional

None listed

Not stated

Academic urban medical center

96

56.9 (12.4)

Range 23–77

65%

White: 28%

Black: 39%

Other: 28%

Asian: 4%

PAM–13; EHFSC-9; SCHFI v 6.2; Control and Attitudes Scale. Kansas City Cardiomyopathy. 3 health literacy questions; Heart Failure Somatic Perception Scale. Patient-Reported Outcomes Measurement Information System short-form; Physical Function, Depression, Anxiety, Fatigue, Applied Cognition, and Sleep Disturbance;

Fisher Exact

Matsuoka et al.,

2016 [56]

(Japan)

Cross-sectional, observational study

None listed

Not stated

Academic and Rural Hospitals

227

67.7 (13.9)

No range

62.6%

None

Japanese version: EHFScBS-9; Health Literacy Scale; NYHA

Multi-variate linear regression analysis

Moaddab et al.,

2020 [57]

(Iran)

Cross sectional, descriptive

None listed

Convenience

Inpatient and outpatient clinic at referral hospital

239

59.04 (9.91)

No range

68.6%

None

SCHFI, CDS, MMSE,CCI

Descriptive statistics including Spearman correlation, Chi square, Fisher's exact test, Mann Whitney, Kruskal Wallis and logistic regression

Muller-Tasch et al.,

2018 [58]

(Germany)

Cross sectional

None listed

Consecutive

Cardiac outpatient units

308

63.6 (12.1)

Range 19–90

74.70%

None

PHQ- 9; EHFScB

Multivariate analysis

Nadrian et al.,

2018 [59]

(Iran)

Secondary analysis. Prospective experimental study

Health Belief Model

Not stated

Heart Hospital

180

53.2 (12.5) Range 20–79

79.80%

None

Do not list tools used/secondary analysis

Regression path analysis

Nesbitt et al.,

2021 [60]

(Australia)

Descriptive correlational

none

Not stated

Public outpatient HF clinics

36

67.5 (11.3)

No range

80.6%

Identified country of birth

General literacy, Rapid estimate of adult literacy in medicine short -form, Short test of functional health literacy in adults, SCHFI, DHFKS

Descriptive statistics using mean, median, IQR, categorical using proportions, correlations Spearman's rho

Ok et al.,

2015 [61]

(Korea)

Correlational

NA

Consecutive

Participants were patients with HF who visited the outpatient cardiology clinics of three tertiary hospitals in a metropolitan area in Korea

280

59.5 (13.83)

No range

65% (182)

None

EHFScBS-9; Duke Activity Status Index; DHFKS, NYHA; MOS- Social Support

Multiple regression analysis

Park et al.,

2020 [62]

(South Korea)

Descriptive, cross sectional

None noted

Convenience

Outpatient

170

67.09 (12.02)

No range

62.4%

None

Sociodemographic characteristics, DS-14, EHFScBS-9 Korean version,

Descriptive statistics, independent t test, one way ANOVA, point by serial correlation Pearson correlation, mediation analysis using PROCESS

Prochota et al.,

2019 [63]

(Poland)

Prospective, observational

None noted

Not stated

Internal medicine department of the health care center in Oleśno

100

73.78 (8.98)

Range 60–88

52%

None

Sociodemographic characteristics, EHFScBS-9, MMSE

Descriptive statistics including percentages and counts for qualitative, Student's t-test, Mann Whitney, ANOVA, Kruskal–Wallis, with post-hoc analyses and Bonferroni correction

Seid et al.,

2019 [64]

(Ethiopia)

Cross sectional

None noted

Not stated

Outpatient clinic at a referral hospital

310

49(19.5)

Range 18–89

35.8%

None

Revised Heart Failure Compliance Scale; JHFKS

Logistic regression

Siabani et al.,

2016 [65]

(Iran)

Cross sectional

NA

Not stated

Inpatient

255

66 (13)

No range

(51.5%) 119

None

Persian version: SCHFI

Univariate analysis, multiple linear regression analysis

Son et al.,

2018 [66]

(South Korea)

Cross sectional

None noted

Convenience

Outpatient clinical at a general hospital

281

68.7(11.1)

No range

60.9%

None

Korean version: of the Frail scale, EHFScBS-9

Independent t test, one way ANOVA, Pearson's correlations, and hierarchical regression

Uchmanowicz et al

2015 [67]

(Poland)

No mention of design but it is cross sectional

None noted

Not stated

Cardiology clinic

110

66.1(11.4)

No range

53.64%

None

Polish version: Tilburg Frailty Indicator; EHFScBS-9

Pearson's, Spearman's rho correlations, stepwise regression

Uchmanowicz et al.,

2017 [68]

(Poland)

Cross sectional

None noted

Not stated

Cardiology clinic

270

72.57(8.23)

No range

48.89%

None

MMSE; EHFScBS-9

ANOVA

Vellone et al., 2015 [69]

(Italy)

Secondary analysis-mention cross sectional in the limitations section

situation specific theory of HF self-care

Not stated

39 CV ambulatory clinics in 29 provinces in Italy

628

73 (11)

No range

58%

None

SCHFI v 6.2; MMSE; CCI

SEM

Vellone et al.,

2017 [70]

(Italy)

Secondary analysis

none reported

Not stated

Cardiovascular outpatient clinics

1192

72.4 (11.2)

No range

58%

None

EHFScBS-9; MMSE, Barthel Index; CCI; QOL SF 12; MLHFQ

ANOVA

Wang et al.,

2020 [71]

(China)

Cross sectional

None reported

Convenience

Hospital

310

68.62 (13.39)

No range

53.2%

None

Sociodemographic characteristics, clinical characteristics, HADS Chinese version, Health Literacy Scale Chinese version, SCHFI-Chines version

Descriptive statistics, correlation, mediation using PROCESS,

Yang & Kang, 2018 [72]

(Korea)

SEM

Theory of Unpleasant symptoms

Convenience

Outpatient clinics

209

67.71

Range 28–89

46.4% male

None

NYHA; Korean version: HADS; Inventory of social supportive behaviors; MSAS-HF; SCHFI

SEM

Zou et al.,

2017 [73]

(China)

Cross sectional

They did use a conceptual model to guide the study see pg. 531

Convenience

Three CV units from a large general university hospital in one province Shandong

321

63.6 (10.6) No range

51.4%

None

Chinese version: SCHFI DASI, HFKT-Ct, Health Literacy Scale for Patients with Chronic Disease; MSPSS; MSSSS

SEM and mediation analysis