الفهرس 
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Abstract
Congestive heart failure (CHF) is a chronic, progressive, complex clinical syndrome in which the heart is incapable of maintaining a cardiac output that is adequate to meet metabolic requirements and accommodate venous return. HF remains a rising global epidemic with an estimated prevalence of more than 37.7 million individuals globally; HF is the leading cause of hospitalization In Egypt, resulting in more than 1 million admissions per year (Kebe et al., 2021).
Self-care is considered a cornerstone of HF treatment; it is a process of maintaining health through health-promoting practices and managing illness. Self-care comprises key behaviors that have been shown to improve clinical outcomes of HF. These behaviors include lifestyle modifications such as adherence to medication, a low-salt diet, exercise, fluid restriction, seeking treatment early after symptom occurrence, and daily measurement of body weight. Self-care behavior (SCB) has been proven to improve patients’ quality of life, facilitate early detection of clinical problems, and reduce the risk of re hospitalization for HF. (Jaarsma, et al., 2021).
Aim of the study:
The present study aimed to:
1. Assess self- care behavior of patients with congestive heart failure.
2. Develop suggested guidelines.
Research Questions:-
The current study was directed to answer the following questions:
1. What is the level of patient’s knowledge about self-care behavior of congestive heart failure?
2. What are the levels of self-care behavior for patients with congestive heart failure?
Subjects and methods:
The study was portrayed under the four main designs as the following:
I. Technical design
II. Operational design
III. Administrative design
IV. Statistical design
I-Technical design:
The technical design includes research design, setting, subjects and tools for data collection used in this study.
Research design:
A descriptive exploratory research design was utilized for the conduction of this study.
Setting:
The study was conducted in the internal medicine department at 1st floor, emergency department each one contains 8 beds and cardiac clinic at Damanhur medical national institute.
Subjects:
A Purposive sample of 60 adult patients with congestive heart failure at the previously mentioned setting.
Tools of data collection:
The following tools were used to achieve the purpose of the current study.
Tool 1: Patient Structured Interview Assessment Questionnaire :It was developed in Arabic language by the researcher after reviewing the recent related literatures. It included the following parts:
Part I: patient’s demographic characteristics: (Appendix I)
This part used to assess patient’s demographic data.
Part II: Patient’s medical data: (Appendix I)
It was included the following, family medical and surgical history, the past and present history of the disease.
Part III: patient’s level of knowledge: (Appendix I)
It was used to assess Patient’s level of knowledge regarding congestive heart failure.
Part IV: patient’s follow up: (Appendix I)
Tool 2: The Self-Care of Heart Failure Index (SCHFI): (Appendix II)
It was developed by investigator in the English language. It divided into three domains measuring self-care maintenance, symptoms perception and self-care management.
Results
The results of this study revealed that:
• 51.7% the studied patients were males and their age were between 60-65 years old and 56.7% of them were married, 53.3% of the studied patients were illiterate, 60% of them did not work. Also, 61.7% of them live in special houses, 75% of the studied patients their house good ventilated.as well, 58.3% of them live in rural area, and 66.7% of studied patients had a financial burden.
• 54% of patient’s under the study didn’t have family history of CHF, 73.3% of them had history of chronic disease, 79.5% of them complained of hypertension, 70% of the studied patients discovered their illness and the first symptoms appeared more than one year ago, 90% of them complained of dyspnea and 30% of studied patients had second degree of congestive heart failure.
• 85% of studied patients had an unsatisfactory level of total knowledge regarding congestive heart failure while 15% of studied patients had a satisfactory level of total knowledge.
• 66.7% of studied patients had in adequate self-care behavior regarding congestive heart failure while 33.3% of studied patients had adequate self-care behavior regarding congestive heart failure.
• There was a high statistical significant with positive correlation between patient’s level of knowledge and educational level, working condition, type of work, number of rooms, income, financial burden due to illness, comorbidities, discovery of illness, appearance of first symptoms and complication from disease.
• There was a statistical significant positive relation between patient’s level of knowledge and age and number of people residing in the residence.
• There was a high statistical significant positive correlation between total patient’s self-care maintenance and educational level, maintaining ideal body weight and There was a statistical significant with positive relation between patient’s self-care maintenance and type of work, type of house, income, financial burden due to illness, complain of other chronic disease, type of congestive heart failure and complication from disease.
• There was a high statistical significant positive relation between total patient’s level of symptoms perception and financial burden due to illness. There was a statistical significant with positive relation between patient’s symptoms perception and educational level, type of congestive heart failure.
• There was a high statistical significant positive correlation between patient’s self-care management and complication from disease.
• There was a high statistical significant positive correlation between total patients level of knowledge and total patients level of self-care regarding congestive heart failure.
Conclusion
Based upon the current study findings, it can be concluded that more than three quarter of the patients under the study had unsatisfactory level of knowledge regarding congestive heart failure, about two thirds of them had in adequate self -care behavior regarding congestive heart failure.
Recommendation
Based on the result of the current study, the following recommendations were inferred from the study:
1. Replication of the current study on a large probability sample selected (national level) including both rural and urban populations to obtain data of more generalizability to achieve generalization of the result.
2. Giving continuous educational program for CHF patients to improve their knowledge and self-care practices regarding congestive heart failure.
3. Further researches are recommended to assess factors affecting patient knowledge and self-care behavior regarding patients with congestive heart failure.
4. Providing evidence based nursing guidelines to improve patient’s knowledge and self-care behavior regarding congestive heart failure