Situation-specific Theory of Heart Failure Self-Care

Contributor: Barbara Riegel
November 8, 2020

Authors – Barbara Riegle, PhD, RN, FAAN and Victoria Vaughan Dickson, PhD, RN, FAHA, FHFSA, FAAN
First published – 2008
© 2020 Riegel
Major Concepts

Self-care maintenance
Symptom perception
Self-care management

Typology – Situation-specific theory
Brief Description

This self-care theory is specific to heart failure, a chronic condition affecting millions of individuals worldwide. Although similar to the middle range theory of chronic illness, which was derived from this theory, the situation specific theory is focused on issues unique to the heart failure patient population. Three core concepts of the theory are self-care maintenance, symptom perception, and self-care management. Self-care maintenance involves the behaviors used to keep an illness like heart failure stable (e.g. medication adherence). Symptom perception is unique in heart failure, with poor interoception impairing the ability of some patients to perceive symptoms. Self-care management involves the response to symptoms once they are recognized. All three of the core behaviors reflected in these concepts have been found to be influenced by self-care self-efficacy or confidence.

Primary Sources

Riegel, B. & Dickson, V.V. (2008). A situation-specific theory of heart failure self-care. Journal of Cardiovascular Nursing, 23(3), 190-196. PMID: 18437059.

Vellone. E., Riegel, B., D’Agostino, F., Fida, R., Gennaro, R., Cocchieri, A., Alvaro, R. (2013) Structural Equation Model Testing the Situation-specific Theory of Heart Failure Self-Care. Journal of Advanced Nursing, 69(11), 2481-2492. PMID: 23521633. DOI: 10.1111/jan.12126

Riegel B, Dickson VV, Faulkner KM. The situation specific theory of heart failure self-care: Revised and updated. Journal of Cardiovascular Nursing, 2016: 31(3), 226-235. PMID: 25774844. DOI: 10.1097/JCN.0000000000000244

Riegel B, Dickson VV. A situation-specific theory of heart failure self-care. In Meleis AI & Im EO. Situation Specific Theories: Development, Utilization, and Evaluation in Nursing. Springer Publishing Company, 2021.

About the Authors   

Barbara Riegel

Barbara Riegel, PhD, RN, FPCNA, FHFSA, FAHA, FAAN is the Edith Clemmer Steinbright Professor of Gerontology at the University of Pennsylvania School of Nursing and Co-Director of the International Center for Self-Care Research. Her research interests are in self-care broadly defined to include treatment adherence, condition monitoring, and self-management of symptoms. Dr. Riegel began studying these issues early in her career while a Clinical Researcher in an acute care setting when hospitals were just beginning to recognize that heart failure was a primary reason for hospital readmissions. She has developed theory and self-report measures of self-care that are used worldwide. Dr. Riegel has received numerous honors and awards including the Distinguished Scientist Award from the American Heart Association, Sigma Theta Tau International Nurse Researcher Hall of Fame, and the Barbara J. Lowery Award from the Doctoral Student Organization at the University of Pennsylvania. 

Victoria Vaughan Dickson

Victoria Vaughan Dickson, PhD, RN, FAHA, FHFSA, FAAN is an Associate Professor and Director of the Pless Center for Nursing Research in the New York University Rory Meyers College of Nursing. With extensive clinical and research experience in cardiovascular and occupational health nursing, her research program focuses on investigating the bio-behavioral influences on self-care in patients with cardiovascular disease risk, coronary heart disease, heart failure and multiple comorbidity; and evaluating the effectiveness of self-care interventions on health outcomes. Her work has led to an improved understanding of the sociocultural influences of self-care among vulnerable populations, including ethnic minority groups, women, and older workers; and the development of innovative theory-based interventions. Dr. Dickson is recognized as an international expert in qualitative and mixed methods research. Her research employs a systematic and rigorous approach that has substantially advanced the “Situation-Specific Theory of Heart Failure Self-Care” and the development of self-care instruments that are used worldwide. Her mentorship to students and collaborations with interdisciplinary research teams across Europe, Asia and South America has contributed to the evolution of the theory. Dr. Dickson is a fellow in the American Academy of Nursing, American Heart Association, Heart Failure Society of America, and New York Academy of Medicine. She is a 2019 inductee into the STTI International Nursing Research Hall of Fame. Dr. Dickson holds a clinical appointment as an advanced practice nurse in the division of cardiology at the NYU Langone Medical Center and the Bellevue Hospital in New York City. She earned her PhD and MSN from the University of Pennsylvania School of Nursing and BSN from Temple University School of Nursing.