**6. Assessments of patients with HF for promoting self-management and supporting their lives**

The self-management process is a process of living life such that symptoms do not worsen while balancing good choices and preferences. By trial and error, the patients with HF try to find the limits of physical capacity and dietary choices that would lead to the worsening of symptoms, while also trying to maintain quality of life to the extent possible [13]. Based on the process of self-management of patients with HF, it is possible to guide the assessment viewpoints to support self-management and their lives. It is important to understand the components of self-management. Components of self-management are "Experience and knowledge about HF," "Self-monitoring and Early perception," and "Life coordination for HF and to live meaningfully." The examples of the assessment viewpoints are shown below.

### **6.1 Experience and knowledge about HF**

Acquisition and experience of knowledge about HF strongly contribute to the improvement of self-care skills, and lack of knowledge may decrease adherence and be a barrier to starting self-care behavior [12, 14]. In addition, patients with HF who understand and recognize the advice of medical professionals benefit the preventing worsening symptoms and readmission that can tend to have good adherence and perform self-care behavior [15]. In the process of self-management, knowledge and understanding of heart failure affect the entire self-management process and need to be continually confirmed even after moving from hospital to home. Assessment viewpoints include—(1) cognition that HF, (2) understanding of causes of HF (**Table 4**).


**Table 4.**

*Assessment of experience and knowledge about HF.*

### **6.2 Self-monitoring and early perception**

It is said that less than half of the patients with HF regularly perform self-monitoring, such as measuring weight and confirming the degree of edema. The receiving treatment tends to be delayed due to the disagreement between the present HF symptoms and the patient's perception, but utilizing past knowledge and experience and receiving high-quality social support, it is possible to respond appropriately and early to the symptoms [16]. Symptom monitoring behavior is also a predictor of appropriate self-care management,


#### **Table 5.**

*Assessment of self-monitoring abilities.*

and regular symptom monitoring for appropriate self-management practice is recommended [17]. To maintain and promote self-monitoring in patients with HF, we need to support patients with HF by performing daily monitoring, integrating knowledge, and past experiences regarding HF to determine how to evaluate their own conditions and take actions. **Table 5** shows the viewpoint of assessment of self-monitoring abilities.
