Objective: This paper identifies common obstacles impeding effective self-management among patients
with heart disease and explores how for disadvantaged patients access barriers interfere with typical
management challenges to undermine patients’ efforts to care for their illnesses.
Methods: We convened 33 focus group discussions with heart patients in 10 U.S. communities. Using
content analysis, we identified and grouped the most common barriers that emerged in focus group
discussions.
Results: We identified nine major themes reflecting issues related to patients’ ability to care for and
manage their heart conditions. We grouped the themes into three domains of interest: (1) barriers that
interfere with getting necessary services, (2) barriers that impede the monitoring and management of a
heart condition on a daily basis, and (3) supports that enable self-management and improve care.
Conclusion: For disadvantaged populations, typical problems associated with self-management of a
heart condition are aggravated by substantial obstacles to accessing care.
Practice implications: Ensuring disadvantaged patients with chronic heart conditions are linked to formal
systems of care, such as cardiac rehabilitation programs, could better develop patients’ self-management
skills, reduce barriers to receiving care and improve the overall health outcomes of these patients