Limitations
The results presented here were derived from secondary analyses of existing data sets and are thus limited. Further research is needed to validate and understand these findings. Most results supported the theory as proposed, but others, such as higher self-care maintenance in patients with lower knowledge scores, require further study. Furthermore, many of the results presented suggest a trend but were not statistically significant. Further testing is essential. An important limitation of this situation-specific theory is that it is a biomedically derived approach to health that focuses on a specific illness. As such, important cultural, gender, and psychosocial influences on self-care are ignored.1 It is essential to recognize that the decision making discussed in relation to the self-care of heart failure is greatly influenced by the broader context in which patients live.
self-care is a particularly important construct because it captures the essence of our philosophy and a key dimension of our practice. The analyses presented in this article confirm that it is important to encourage self-care in our patients, as those who engage in self-care seem to have better outcomes. These analyses also suggest that we may be able to identify the patients most at risk for poor self-care. If this is true, in the future, we may eventually be able to identify those patients most in need of an intervention to improve self-care. Another important implication from this discussion is the need to use consistent terms so that we are able to communicate clearly about the subtleties of self-care. If we all use different terms, we will have difficulty communicating our points to each other. Finally, if future research continues to support the importance of confidence in the self-care equation, interventions aimed at improving self-care confidence need to be developed and tested. In conclusion, in this article, a situation-specific theory of heart failure self-care is presented. Four propositions were tested, which provided preliminary evidence that the theory is useful for explanation and p Im and Meleis3 note that there are probably several reasons for the seeming disconnect among theory, research, and practice, but one likely reason is the tension between theoretical vision and clinical wisdom. Situation-specific theories such as the self-care of heart failure theory described here may be one way of linking theory, research, and clinical practice. The theory described here directly reflects the experiences of clinicians in their daily practice. As such, it is hoped that this theory might provide guidance for both clinical intervention and research.rediction. With further testing, the theory may prove useful in situations where we seek to control outcomes.