Aims: This integrative review aims to describe the current evidence concerning the relationship between a broad range of psychological factors (depression, depressive symptoms, anxiety, stress, and type-D personality) and self-care in patients with heart failure. Methods and results: Six electronic databases were searched and keywords were used to identify potential eligible studies published within the last 10 years. To be eligible, individuals with heart failure aged 18 years or older and who were included in any type of observational study that examined the association between psychological factors and self-care were considered. Twenty articles were included, and 16 of them reported that depression/depressive symptoms were associated with poorer self-care, after controlling for age, sex, education level, cardiac history, or comorbidities. Five studies found that self-care confidence/self-efficacy mediates the relationship between depression/depressive symptoms and self-care. The association between depression/depressive symptoms and self-care varied in assessment methods and statistical approaches. Seven studies showed an inverse association between anxiety and self-care. Four studies found a stronger association between self-care and depression compared with the relationship between self-care and other psychological factors. Stress and type-D personality were both associated with self-care in four studies. Conclusion: Depression/depressive symptoms and anxiety were found to be inversely associated with self-care in patients with heart failure. Depression exhibited a stronger impact on self-care than other psychological factors. Limited studies assessed stress and type-D personality; the results should be considered with caution. Further studies are warranted on different psychological factors and their underlying mechanisms in individuals with heart failure.

Background: Individuals with heart failure (HF), a debilitating disease with ongoing adaptation and management, are often cared for by partner caregivers whose needs and voices are overshadowed by the demands of HF management. With multidimensional needs and complex challenges for individuals with HF, partner caregivers have to deal with uncertainty and need guidance. Given the vital role of partners, attention should be drawn toward understanding the experience of HF partner caregivers. Objective: The aim of this study was to synthesize existing qualitative evidence related to caregivers' views and experiences of caring for their partners with HF. This knowledge would assist healthcare providers to better meet the demand of partners and provide them with effective guidance. Methods: A meta-ethnography of qualitative evidence was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations for reporting systematic reviews. A comprehensive search of PubMed, Scopus, ISI Web of Science, CINAHL, PsycINFO, and EMBASE, as well as hand searches of the reference lists from included articles, was conducted. A combination of subject terms including MeSH and keywords related to HF, partner experience, and qualitative methods was used to identify studies. Studies were included if they were published in English between January 2000 and December 2020 and examined caregivers' experiences in providing care for their partner with HF by using qualitative methods. Results: Ten articles were included, with 178 participants, and most partners were female. Five studies were conducted in the United States, and 4 studies were conducted in Sweden. Five studies reported partners' health problems; 8 of the studies delineated the inclusion and exclusion criteria for partners. Five overarching themes emerged: shouldering the responsibility, being overloaded, bearing emotional burdens, staying positive, and “left in the dark,” craving support from others. Conclusions and Clinical Implications: Given the complex roles in caring for individuals with HF, more qualitative research is strongly warranted to enhance caregivers' support and education. A deeper and more comprehensive understanding of the experiences of caregivers for partners with HF is essential for developing tailored interventions. Healthcare providers should be aware of the importance of ongoing assessment and evaluate partner caregivers' needs and assist them in providing more information and formulating coping strategies as required.

The concept of symptom clusters in heart failure (HF) has been defined and measured inconsistently. We used Rodgers’ evolutionary method to review related concepts in the HF literature. Symptom clusters and symptom cluster profiles are characterized by multiple symptoms, a synergistic relationship, and result in a myriad of poor outcomes. Researchers should carefully consider the conceptual differences underpinning symptom clusters and symptom cluster profiles and choose the appropriate concept aligned with their research questions, empirical methods, and target HF population.

Aims. To adapt the Authentic Nurse Leadership Questionnaire (ANLQ) to the Chinese cultural context and evaluate its psychometric properties. Background. Authenticity serves as a pivotal factor in the dynamic interaction between nurse leaders and nurse staff, exerting a profound influence on the growth of nurse individuals, healthcare teams, and organizations. However, there is still a dearth of research instruments to assess nurses perception of authentic leadership in China. Methods. After authorization from the original author and technical support had been secured, a systematic process of initial translation, back translation, expert panel review, and pretesting was employed to ensure cross-cultural adaptation in accordance with established guidelines. A two-stage study design was implemented. In stage 1, 189 nurses were sampled for psychometric validation, during which the internal consistency reliability, split-half reliability, and test-retest reliability were tested and exploratory factor analysis was performed. In stage 2, 255 nurses were sampled for confirmatory factor analysis and assessment of convergent and discriminant validity, to further validate the constructs. Results. In stage 1, the validated instrument showed a Cronbachs alpha value of 0.973, a split-half coefficient of 0.888, and a test-retest reliability coefficient of 0.912. The exploratory factor analysis extracted five dimensions that accounted for 82.629 of the overall variance. The findings in stage 2 showed that the observed data were well fitted to the five-factor theoretical model, with acceptable levels of convergent and discriminant validity. Conclusions. The Chinese version of the ANLQ demonstrated appropriate psychometric properties, as evidenced by its good reliability and validity. Implications for Nursing Management. This study offers nurse administrators and executives a valuable instrument, enabling them to establish leadership evaluation criteria, conduct nurse leader performance appraisals, and assist in selecting new nurse leaders. Ultimately, this contributes to the cultivation and development of exceptional managers capable of providing positive leadership to their followers.