Abstract
BACKGROUND: Effective volume management can significantly improve patients' health outcomes, but the current situation of volume management in older patients with chronic heart failure (CHF) and multimorbidity is not optimistic. This study aimed to explore the facilitators and barriers of self-volume management in patients and to provide a basis for the development of self-volume management strategies. METHODS: A descriptive qualitative research method was used. Semi-structured interviews were conducted with older patients with CHF and multimorbidity between January and April 2025 in two tertiary hospitals in Shanghai, China. Data were analyzed using content analysis. RESULTS: Eight facilitators emerged, including the hospital-community collaboration mechanism, Medicare and long-term care insurance coverage, diverse social support, the doctor-patient trust relationship, results-oriented incentives, digital health management, high self-efficacy, and strong motivation for health. Nine barriers were identified; these were insufficient adaptability of self-volume management programs, limited access to community resources, lack of standardized self-volume management tools, inadequate multidisciplinary team communication, one-way doctor-patient communication, lack of knowledge of self-volume management, physical limitations, management negligence caused by work constraints, and behavioral habits' consolidation. CONCLUSIONS: Self-volume management was affected by various factors. The study suggests strengthening health insurance coverage to reduce financial burden, taking advantage of family support and providing digital health management tools. In addition, healthcare providers should provide patient-centered care, enhance multidisciplinary collaboration, and address individual barriers with precise intervention strategies.