Document Type : Research articles


1 Social Determinants of Health Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.

2 Department of Psychology, Faculty of Humanities, Marand Branch, Islamic Azad University, Marand, Iran

3 Department of Psychology, School of Humanities, Education and Social Sciences, Khazar University, Baku, Azerbaijan


Background: Patients with heart failure need to be engaged in adequate cardiac self-care behaviors helping to prevent the development of the disease and ameliorate their health status. However, the conceptual model of the present study has not been tested in previous studies among patients with heart failure.
Objectives: The present study aimed to investigate the psychosocial determinants based on Penders health promotion model (HPM) affecting self-care behavior among outpatients suffering from heart failure.
Methods: In this cross-sectional study, a total of 200 patients suffering from heart failure were selected from the outpatient clinics of Tabriz, Iran, using convenience sampling and assessed for self-self-care behaviors and major concepts of HPM via self-administered questionnaires. Path analysis was used in order to analyze the conceptual model
Results: The present hypothetical model showed a good fit. Perceived benefits and activity-related effects directly affected self-care behaviors. Bootstrapping mediation analyses indicated that perceived self-efficacy, perceived barriers, perceived benefits, and activity-related effects indirectly affected self-care behaviors through commitment to action.
Conclusions: The commitment to action can help to promote self-care behaviors among the subjects suffering from heart failure. The interventions should take the role of predictive variables of this study and commitment to action into account in these patients.