**4. Importance of self-management for patients with HF**

HF is one of the most common causes of hospital admissions and readmissions. A recent review revealed that nurse-led hospital-to-home transitional care interventions reduced the risk of all-cause mortality and heart failure-related hospitalizations, and improved health-related quality of life (HRQOL) and heart failure knowledge compared to usual care. The narrative summary of evidence for self-care behaviors showed positive intervention effects [10, 11]. Generally, nurse-led hospital-to-home transitional care interventions may play a beneficial role in decreasing mortality and improving HRQOL and self-care behaviors for patients with HF. Therefore, self-management is the cornerstone of HF management. Self-management comprises adherence to behaviors, such as maintaining a low sodium diet and medication regimen, as well as symptom monitoring to maintain physiological stability and response to symptoms when they occur [12]. However, there are some concerns. First, previous studies have different contents and modes of intervention, evaluation tools, and there is a publication bias in the outcome of quality of life, which might lead to selection bias, detection bias, and attention bias. Second, due to the diverse durations of interventions and length of follow-up, these factors may affect the long-term effects of self-management interventions. As stated above, further considerations are needed to show the optimal self-management interventions in patients with HF.
