Impact of stress coping style on self-care behaviors and prognosis in patients with heart failure: A prospective longitudinal observational study

Heart failure (HF) requires effective management and self-care education to improve outcomes. However, daily self-care routines necessary for managing HF can lead to psychological issues, including stress, potentially exacerbating the condition. Patient stress-coping behaviors may significantly impact prognosis. We aimed to identify stress coping styles in patients with HF and examine their impact on self-care behavior and prognosis. s. This study utilized a longitudinal prospective observational design. Patients were categorized into task-oriented (task), emotion-oriented (emotion), and avoidance (avoidance) coping groups using the Coping Inventory for Stress Situations. Stress levels and self-care behaviors were evaluated during hospitalization and 1 and 3 months after discharge. The primary outcome was a composite of HF readmission and all-cause mortality during the 180-day post-discharge period. Longitudinal changes in self-care behaviors were assessed according to stress intensity. We included 151 patients (age, 74 [60–80] years; female, 37.1 %) hospitalized for HF exacerbation between August 2021 and August 2023. The task group comprised 45 patients (29.8 %); emotion group, 47 (31.1 %); and avoidance group, 59 (39.1 %). The avoidance group had a higher risk of adverse events during follow-up (task, emotion, and avoidance: 8.9 % vs. 14.9 % vs. 32.2 %, p = 0.004). The avoidance-coping style was the only independent predictor of the primary outcome (hazard ratio: 3.84, 95 % confidence interval: 1.40–10.53, p = 0.009). Self-care behaviors were notably poorer in the avoidance group, particularly under conditions of high stress. Stress-coping strategies impact both prognosis and self-care outcomes in patients with HF, and education programs should consider incorporating these strategies. •Avoidance-coping is linked to higher HF readmissions and mortality.•Stress-coping styles significantly affect self-care behaviors.•Task-oriented coping is associated with better patient outcomes.