Perceptions of fluid restriction self-care in heart failure

Objectives: Daily fluid restriction reduces fluid retention and therefore lessens the symptom burden of heart failure but the literature shows that adherence is sub-optimal. The objectives of the current study were to understand patients’ experiences of fluid restriction self-care and identify factors affecting adherence.

Methods: Semi-structured interviews were conducted with four inpatients. Data were interpreted using the World Health Organization’s dimensions affecting adherence; these dimensions were patient-related, condition-related, therapy-related, health system/team-related and socioeconomic-related.

Findings: Fluid restriction self-care was unpleasant and challenging. The most commonly reported factors were in the therapy-related dimension, and included unrelenting, uncomfortable thirst and dry mouth, which were a cause of significant distress. Patients reported unease about the complexity of the condition, misunderstood the treatment rationale and were confused about the benefit of adherence.

Conclusions: The current study supports the current consensus that self-care for long-term conditions is complex and challenging. More patient-focused research is advised to address difficulties in adhering to fluid restriction. Improvement in thirst and dry-mouth alleviation strategies is needed.