Treatment-related factors include a complex medical
regimen requiring life-style changes, life-long treatment,
experience with previous successful or failed treatments,
frequent changes in treatment strategies, varying lengths of
time before experiencing positive effects of the treatment
and severe side-effects requiring medical support [15].
For the person with HF, compliance with the prescribed
medical regimen is far more complicated than simply
following the recommendation to take a combination of
medications. Patients also are asked to restrict salt and
perhaps fluids in the diet, avoid alcohol, quit smoking,
exercise regularly, and monitor fluid balance daily by
measuring body weight [30]. Patients describe difficulty
coping with the treatment recommendations such as
diuretics; one woman described her urgent need to find a
toilet and subsequent need to wear diapers. Dietary salt
restrictions made food taste bland and unpalatable. Many
patients had other co-morbid illnesses such as diabetes,
which created even more food restrictions [48].
For many patients, this treatment regimen requires major
behavioural changes, and as the perceived difficulty of the
required behaviour increases, the level of compliance
decreases