Conclusion
Two distinct trajectories of change in HF self-care management behaviors over six months were identified. Patients who had a decline in self-care management had no significant change in HRQOL. In contrast, patients who had improvements in self-care management also had concomitant improvements in HRQOL. Worse physical symptoms, greater left ventricular dilatation and ischemic etiology were associated with greater odds of having a decline in HF self-care management over time, whereas those with greater depression were more likely to improve in HF self-care management over six months. These results have implications for clinicians and researchers alike who are interested in optimizing self-care management behaviors of adults with HF. Specifically, a one-size-fits-all strategy or intervention may not result in improved self-care, as there are unique and naturally-occurring patterns of change in self-care management that warrant tailored approaches.