{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T19:06:05Z","timestamp":1791140765656,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001778","name":"Deakin University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001778","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2024,10]]},"abstract":"Abstract<\/jats:title>\n \n Aim<\/jats:title>\n To explore the cognitive representations and emotional responses to living with chronic heart failure of people receiving limited community disease management.<\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n Individuals living with heart failure face self\u2010care and emotional challenges due to the overwhelming nature of adapting to lifestyle changes, particularly in subtropical areas.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Qualitative descriptive. We applied Leventhal's Common Sense Model of Self\u2010Regulation as the framework for interviews and analyses.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Twenty patients with chronic heart failure were interviewed during a hospital admission for exacerbation of their condition in a tertiary hospital in Thailand.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Analysis of the components of Leventhal's model of cognitive representations of illness revealed two themes relating to\n Illness Identity<\/jats:italic>\n : (1) lack of knowledge of the diagnosis and how to recognise symptoms of the disease, and (2) recognition of symptoms of an exacerbation of CHF was based on past experience rather than education. These resulted in delays responding to cardiac instability and confusion about the intent of treatment. Participants recognised the chronicity of their disease but experienced it as an unrelenting cycle of relative stability and hospitalisations. Perceived\n Controllability<\/jats:italic>\n was low. Two themes were: (1) Low perceived trust in the efficacy of medical treatment and lifestyle changes, and (2) Low perceived trust in their ability to comply with recommended lifestyle changes. The\n Consequences<\/jats:italic>\n were significant emotional distress and high burden of disease. The two themes of emotional responses were (1) Frustration and hopelessness with the uncertainty and unpredictability of the disease, and (2) Sense of loss of independence, functional capacity and participation in life's activities.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Chronically ill patients need support to understand their illness and make better treatment and lifestyle decisions. Improving patients' self\u2010efficacy to manage treatment and symptom fluctuations has the potential to improve their mental well\u2010being and minimise the impact of their condition on suffering and participation in employment and community.<\/jats:p>\n <\/jats:sec>\n \n Implications for the Profession and\/or Patient Care<\/jats:title>\n Leventhal's Common Sense Model of Self\u2010Regulation can be used to examine cognitive and emotional elements of illness perceptions, which link to individuals' ability to make informed decisions about disease management and influence health behaviours. Understanding illness perceptions underpins strategies for enhancing and sustaining self\u2010management behaviours.<\/jats:p>\n <\/jats:sec>\n \n Impact<\/jats:title>\n The study findings accentuate the need to establish long\u2010term condition support programs in low\u2010middle income countries where the burden of heart failure is increasing exponentially.<\/jats:p>\n <\/jats:sec>\n \n Reporting Method<\/jats:title>\n The Consolidated Criteria for Reporting Qualitative Research (COREQ) guideline was used to explicitly and comprehensively report our qualitative research.<\/jats:p>\n <\/jats:sec>\n \n Patient or Public Contribution<\/jats:title>\n Patients contributed to the conduct of the study by participating in the data collection via face\u2010to\u2010face interviews.<\/jats:p>\n 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