Abstract
BACKGROUND: Self-care behavior has been reported to be below optimum in persons with heart failure, while the underlying decision making is not well understood. The Hot/Cool System model is a psychological model that may have potential applications in decision making process in persons with heart failure. The aim of this study was to examine the decision making process in self-care behavior in persons with heart failure in the light of the Hot/Cool System model. METHODS: We used the Hoot/Cool System Model to guide this study. Participants with heart failure from in-patients setting (N = 107) were recruited. Data were collected using self-report questionnaires. Moderated mediation analysis was used to study complex relationships among study variables. RESULTS: The current study showed that impulsivity and perceived stress were negatively associated with self-care behavior. The results also showed that self-care confidence and impulsivity significantly predict self-care maintenance. The moderated mediation analysis revealed that self-care confidence mediated the relationship between impulsivity and self-care maintenance at lower levels of perceived stress, but not at higher levels of perceived stress. CONCLUSION: Our findings revealed that persons with heart failure tend to make impulsive choices that may negatively affect disease progression under higher levels of perceived stress. This study provides foundational knowledge regarding the decision making process in persons with heart failure.