Background. Cardiovascular disease (CVD) is a major cause of increased morbidity and mortality globally. Clinical practice guidelines recommend that individuals with CVD are routinely instructed to engage in self-care including diet restrictions, medication adherence, and symptom monitoring. Objectives. To describe the nature of nurse-led CVD self-care interventions, identify limitations in current nurse-led CVD self-care interventions, and make recommendations for addressing them in future research. Design. Integrative review of nurse-led CVD self-care intervention studies from PubMed, MEDLINE, ISI Web of Science, and CINAHL. Primary studies ( ) that met the inclusion criteria of nurse-led RCT or quasiexperimental CVD self-care intervention studies (years 2000 to 2012) were retained and appraised. Quality of the review was assured by having at least two reviewers screen and extract all data. Results. A variety of self-care intervention strategies were studied among the male (57%) and Caucasian (67%) dominated samples. Combined interventions were common, and quality of life was the most frequent outcome evaluated. Effectiveness of interventions was inconclusive, and in general results were not sustained over time. Conclusions. Research is needed to develop and test tailored and inclusive CVD self-care interventions. Attention to rigorous study designs and methods including consistent outcomes and measurement is essential. 1. Introduction Cardiovascular disease (CVD) is a major cause of morbidity and mortality worldwide [1]. It is estimated that 1 in 3 American adults have CVD. After age of 40, the lifetime risk of developing CVD is 49% for men and 32% for women [2]. Although advances in medical and surgical management of CVD have substantially reduced cardiac mortality rates in the United States (US), individuals with CVD remain at increased risk for further cardiac events, including unstable angina, myocardial infarction, and heart failure [1]. Cardiovascular disease in the US costs more than $108 billion each year [3], which includes the cost of health care services, medications, and lost productivity. Individuals with CVD are routinely instructed to engage in self-care behaviors as part of daily disease management. Numerous terms are used interchangeably with self-care including self-management, self-regulation, self-monitoring, adherence, and compliance to describe the behaviors or activities in which patients are asked to engage in to promote health and well-being [4]. In the cardiovascular literature, self-care refers to adherence to treatment
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