Adherence to Self-Care Behaviors and Associated Factors among Adult Heart Failure Patients Attending Chronic Follow-Up Care at Jimma University Medical Center, Southwest Ethiopia

Temesgen Mulugeta1, *, Desalegn Duguna1, Azmeraw Bekele2, Belachew Umeta3
1 Jimma University, Institute of Health, School of Pharmacy, Clinical Pharmacy Unit, Jimma, Oromia, Ethiopia
2 Jimma University, Institute of Health, School of Pharmacy, Social Pharmacy Unit, Jimma, Oromia, Ethiopia
3 Jimma University, Institute of Health, School of Pharmacy, Pharmaceutical Quality Assurance and Regulatory Affairs Unit, Jimma, Oromia, Ethiopia

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© 2022 Mulugeta et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Jimma University, Institute of Health, School of Pharmacy, Clinical Pharmacy Unit, Jimma, Oromia, Ethiopia; E-mail:



Optimal outcomes and quality of life in patients with heart failure (HF) depend on effective self-care activities. However, patients may experience difficulties, and their performance may be inconsistent.


To determine the level of adherence to self-care behaviors and associated factors among adult HF patients attending chronic follow-up care at Jimma University Medical Center (JUMC).


A cross-sectional study was conducted between August and September 2021. Data were collected through face-to-face interviews and by reviewing patients’ medical records. The collected data were analyzed using SPSS version 25 and the findings were presented in frequency, percentage, mean (SD), and median (IQR). Multivariate logistic regression was performed to determine factors associated with adherence to self-care behaviors. Odds ratios with 95% confidence intervals and p-values were used to report the findings.


Out of 266 HF patients, 50.0% had good adherence towards self-care behavior recommendations. The highest following recommendation was taking medication as prescribed (75.5%), followed by a dietary recommendation of a low-salt diet (45.2%). Participants who could not read and write (adjusted odds ratio (AOR) = 0.30 (95% confidence interval (CI) 0.13, 0.71), P = 0.006), had an illness duration greater than or equal to ten years (AOR = 0.31 (95% CI 0.12, 0.82), P = 0.02), in the NYHA class II HF (AOR = 0.33 (95% CI 0.15, 0.73), P = 0.007) were negatively associated with good adherence to self-care behavior recommendations.


In this study, only half of the respondents had good adherence to self-care behaviors. Lower educational level, longer illness duration, and NYHA class II HF were predictors of poor adherence to self-care. Therefore, nurses should devise strategies to counsel or educate the HF patients on self-care practice recommendations, particularly patients with a lower education level and who lived longer with HF.

Keywords: Adherence, Adherence score, Self-care behaviors, Self-care maintenance, Adults, Heart failure.