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Peer-reviewedCC BY 4.0Frontiers in Cardiovascular Medicine

The will to live, illness representations, hope, and heart failure self-care

  1. 1School of Nursing, University of North Carolina Wilmington, Wilmington, NC, United States

Abstract

Background: Heart failure (HF) remains one of the most prevalent cardiovascular diseases worldwide. Effective management requires both medical treatment and patient engagement in self-care activities. Because self-care can be challenging to sustain, understanding the factors that are associated with self-care behaviors is essential. Illness threat, coping resources, and self-care efficacy may affect heart failure self-care (HFSC). The will to live (WTL) and hope, as coping-related resources, may motivate individuals with HF to engage in self-care and strengthen their confidence in managing their condition.

Objective: To examine the associations among illness threat, will to live, hope, and heart failure self-care.

Methods: Moderation analyses and multiple regression were conducted using survey data from 204 adults with heart failure.

Results: Illness threat did not significantly influence HFSC and was not moderated by WTL or hope. In contrast, both WTL and hope were positively associated with HFSC and self-care efficacy.

Conclusion: Across all HFSC domains—maintenance, monitoring, management, and self-care efficacy—WTL and hope emerged as consistent and significant correlates. Illness threat showed weak or non-significant associations with HFSC and did not interact with WTL or hope in predicting self-care behaviors. These findings suggest that coping and dispositional resources may play a more central role in HFSC engagement than illness perceptions alone. Interventions that focus primarily on emphasizing illness threat may be less effective than those that assess and strengthen patients’ hope, will to live, and sense of agency in managing their condition.

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BibTeX
@article{kleman2026will,
  title = {{The will to live, illness representations, hope, and heart failure self-care}},
  author = {Carolyn Kleman and Kayla Alderson and Chris Evonko and Caroline Jenkins and Nia Lewis and Stephanie Turrise},
  journal = {Frontiers in Cardiovascular Medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fcvm.2026.1899596},
  url = {https://doi.org/10.3389/fcvm.2026.1899596},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - The will to live, illness representations, hope, and heart failure self-care
AU  - Carolyn Kleman
AU  - Kayla Alderson
AU  - Chris Evonko
AU  - Caroline Jenkins
AU  - Nia Lewis
AU  - Stephanie Turrise
PY  - 2026
DA  - 2026/10/12
JO  - Frontiers in Cardiovascular Medicine
DO  - 10.3389/fcvm.2026.1899596
UR  - https://doi.org/10.3389/fcvm.2026.1899596
AB  - Background: Heart failure (HF) remains one of the most prevalent cardiovascular diseases worldwide. Effective management requires both medical treatment and patient engagement in self-care activities. Because self-care can be challenging to sustain, understanding the factors that are associated with self-care behaviors is essential. Illness threat, coping resources, and self-care efficacy may affect heart failure self-care (HFSC). The will to live (WTL) and hope, as coping-related resources, may motivate individuals with HF to engage in self-care and strengthen their confidence in managing their condition.  Objective: To examine the associations among illness threat, will to live, hope, and heart failure self-care.  Methods: Moderation analyses and multiple regression were conducted using survey data from 204 adults with heart failure.  Results: Illness threat did not significantly influence HFSC and was not moderated by WTL or hope. In contrast, both WTL and hope were positively associated with HFSC and self-care efficacy.  Conclusion: Across all HFSC domains—maintenance, monitoring, management, and self-care efficacy—WTL and hope emerged as consistent and significant correlates. Illness threat showed weak or non-significant associations with HFSC and did not interact with WTL or hope in predicting self-care behaviors. These findings suggest that coping and dispositional resources may play a more central role in HFSC engagement than illness perceptions alone. Interventions that focus primarily on emphasizing illness threat may be less effective than those that assess and strengthen patients’ hope, will to live, and sense of agency in managing their condition.
SN  - 2297-055X
ER  -