Abstract：
OBJECTIVE: To explore the cognitive representations and emotional responses to living with chronic heart failure of people receiving limited community disease management.
BACKGROUND: Individuals living with heart failure face self-care and emotional challenges due to the overwhelming nature of adapting to lifestyle changes, particularly in subtropical areas.
METHODS: Qualitative descriptive. We applied Leventhal\'s Common Sense Model of Self-Regulation as the framework for interviews and analyses.
METHODS: Twenty patients with chronic heart failure were interviewed during a hospital admission for exacerbation of their condition in a tertiary hospital in Thailand.
RESULTS: Analysis of the components of Leventhal\'s model of cognitive representations of illness revealed two themes relating to Illness Identity: (1) lack of knowledge of the diagnosis and how to recognise symptoms of the disease, and (2) recognition of symptoms of an exacerbation of CHF was based on past experience rather than education. These resulted in delays responding to cardiac instability and confusion about the intent of treatment. Participants recognised the chronicity of their disease but experienced it as an unrelenting cycle of relative stability and hospitalisations. Perceived Controllability was low. Two themes were: (1) Low perceived trust in the efficacy of medical treatment and lifestyle changes, and (2) Low perceived trust in their ability to comply with recommended lifestyle changes. The Consequences were significant emotional distress and high burden of disease. The two themes of emotional responses were (1) Frustration and hopelessness with the uncertainty and unpredictability of the disease, and (2) Sense of loss of independence, functional capacity and participation in life\'s activities.
CONCLUSIONS: Chronically ill patients need support to understand their illness and make better treatment and lifestyle decisions. Improving patients\' self-efficacy to manage treatment and symptom fluctuations has the potential to improve their mental well-being and minimise the impact of their condition on suffering and participation in employment and community.
UNASSIGNED: Leventhal\'s Common Sense Model of Self-Regulation can be used to examine cognitive and emotional elements of illness perceptions, which link to individuals\' ability to make informed decisions about disease management and influence health behaviours. Understanding illness perceptions underpins strategies for enhancing and sustaining self-management behaviours.
CONCLUSIONS: The study findings accentuate the need to establish long-term condition support programs in low-middle income countries where the burden of heart failure is increasing exponentially.
UNASSIGNED: The Consolidated Criteria for Reporting Qualitative Research (COREQ) guideline was used to explicitly and comprehensively report our qualitative research.
UNASSIGNED: Patients contributed to the conduct of the study by participating in the data collection via face-to-face interviews.
BACKGROUND: Individuals living with heart failure face self-care and emotional challenges due to the overwhelming nature of adapting to lifestyle changes, particularly in subtropical areas.
METHODS: Qualitative descriptive. We applied Leventhal\'s Common Sense Model of Self-Regulation as the framework for interviews and analyses.
METHODS: Twenty patients with chronic heart failure were interviewed during a hospital admission for exacerbation of their condition in a tertiary hospital in Thailand.
RESULTS: Analysis of the components of Leventhal\'s model of cognitive representations of illness revealed two themes relating to Illness Identity: (1) lack of knowledge of the diagnosis and how to recognise symptoms of the disease, and (2) recognition of symptoms of an exacerbation of CHF was based on past experience rather than education. These resulted in delays responding to cardiac instability and confusion about the intent of treatment. Participants recognised the chronicity of their disease but experienced it as an unrelenting cycle of relative stability and hospitalisations. Perceived Controllability was low. Two themes were: (1) Low perceived trust in the efficacy of medical treatment and lifestyle changes, and (2) Low perceived trust in their ability to comply with recommended lifestyle changes. The Consequences were significant emotional distress and high burden of disease. The two themes of emotional responses were (1) Frustration and hopelessness with the uncertainty and unpredictability of the disease, and (2) Sense of loss of independence, functional capacity and participation in life\'s activities.
CONCLUSIONS: Chronically ill patients need support to understand their illness and make better treatment and lifestyle decisions. Improving patients\' self-efficacy to manage treatment and symptom fluctuations has the potential to improve their mental well-being and minimise the impact of their condition on suffering and participation in employment and community.
UNASSIGNED: Leventhal\'s Common Sense Model of Self-Regulation can be used to examine cognitive and emotional elements of illness perceptions, which link to individuals\' ability to make informed decisions about disease management and influence health behaviours. Understanding illness perceptions underpins strategies for enhancing and sustaining self-management behaviours.
CONCLUSIONS: The study findings accentuate the need to establish long-term condition support programs in low-middle income countries where the burden of heart failure is increasing exponentially.
UNASSIGNED: The Consolidated Criteria for Reporting Qualitative Research (COREQ) guideline was used to explicitly and comprehensively report our qualitative research.
UNASSIGNED: Patients contributed to the conduct of the study by participating in the data collection via face-to-face interviews.
摘要：
目的：探讨接受有限社区疾病管理的慢性心力衰竭患者的认知表征和情绪反应。
背景：由于适应生活方式变化的压倒性性质，患有心力衰竭的人面临自我护理和情感挑战，特别是在亚热带地区。
方法：定性描述性。我们应用Leventhal的自我调节常识模型作为访谈和分析的框架。
方法：泰国一家三级医院的20名慢性心力衰竭患者因病情加重而入院时接受了访谈。
结果：对Leventhal疾病认知表征模型的组成部分的分析揭示了与疾病身份有关的两个主题：（1）缺乏对诊断和如何识别疾病症状的知识，（2）对CHF加重症状的认识是基于过去的经验而不是教育。这些导致对心脏不稳定的反应延迟和对治疗意图的混淆。参与者认识到他们疾病的慢性，但经历了相对稳定和住院的不屈不挠的循环。感知可控性较低。两个主题是：(1)对医疗效果和生活方式改变的低感知信任，(2)对他们遵守推荐的生活方式改变的能力的信任度较低。其后果是显著的情绪困扰和高疾病负担。情绪反应的两个主题是（1）沮丧和绝望与疾病的不确定性和不可预测性，(2)失去独立感，功能能力和对生活活动的参与。
结论：慢性病患者需要得到支持，以了解他们的病情，并做出更好的治疗和生活方式决定。改善患者的自我效能以管理治疗和症状波动有可能改善他们的心理健康，并最大程度地减少他们的病情对痛苦和参与就业和社区的影响。
■Leventhal的自我调节常识模型可用于检查疾病感知的认知和情绪因素，这与个人做出关于疾病管理和影响健康行为的知情决策的能力有关。了解疾病观念是加强和维持自我管理行为的策略的基础。
结论：研究结果强调了在心力衰竭负担呈指数增长的中低收入国家建立长期病情支持计划的必要性。
■定性研究报告综合标准（COREQ）指南用于明确和全面地报告我们的定性研究。
■患者通过面对面访谈参与数据收集，为研究的进行做出了贡献。
背景：由于适应生活方式变化的压倒性性质，患有心力衰竭的人面临自我护理和情感挑战，特别是在亚热带地区。
方法：定性描述性。我们应用Leventhal的自我调节常识模型作为访谈和分析的框架。
方法：泰国一家三级医院的20名慢性心力衰竭患者因病情加重而入院时接受了访谈。
结果：对Leventhal疾病认知表征模型的组成部分的分析揭示了与疾病身份有关的两个主题：（1）缺乏对诊断和如何识别疾病症状的知识，（2）对CHF加重症状的认识是基于过去的经验而不是教育。这些导致对心脏不稳定的反应延迟和对治疗意图的混淆。参与者认识到他们疾病的慢性，但经历了相对稳定和住院的不屈不挠的循环。感知可控性较低。两个主题是：(1)对医疗效果和生活方式改变的低感知信任，(2)对他们遵守推荐的生活方式改变的能力的信任度较低。其后果是显著的情绪困扰和高疾病负担。情绪反应的两个主题是（1）沮丧和绝望与疾病的不确定性和不可预测性，(2)失去独立感，功能能力和对生活活动的参与。
结论：慢性病患者需要得到支持，以了解他们的病情，并做出更好的治疗和生活方式决定。改善患者的自我效能以管理治疗和症状波动有可能改善他们的心理健康，并最大程度地减少他们的病情对痛苦和参与就业和社区的影响。
■Leventhal的自我调节常识模型可用于检查疾病感知的认知和情绪因素，这与个人做出关于疾病管理和影响健康行为的知情决策的能力有关。了解疾病观念是加强和维持自我管理行为的策略的基础。
结论：研究结果强调了在心力衰竭负担呈指数增长的中低收入国家建立长期病情支持计划的必要性。
■定性研究报告综合标准（COREQ）指南用于明确和全面地报告我们的定性研究。
■患者通过面对面访谈参与数据收集，为研究的进行做出了贡献。
