Symptom Management in Chronic Heart Failure: Strategies and Behaviours From Patients’ Perspectives—A Scoping Review

INTRODUCTION: Chronic heart failure (CHF) affects millions and burdens health systems through high morbidity and mortality. Guidelines emphasise the need for self-management. Yet the specific strategies patients use to perceive, appraise, and respond to symptoms remain insufficiently described. Symptom management is a core component of self-management and directly shapes illness trajectories and quality of life. OBJECTIVES: To identify and map behaviours and strategies of adults with CHF to manage symptoms in daily life. METHODS: We conducted a scoping review of MEDLINE (PubMed), CINAHL (EBSCOhost), Livivo and Cochrane Library (2006-2024). Data were analysed using Mayring's qualitative content analysis. Categories were derived deductively from heart failure guidelines and Dodd's Symptom Management Model and inductively from included studies. The category system was aligned with Dodd's Symptom Management Model, which guided the structuring of findings into symptom experience, management strategies, and outcomes. RESULTS: Thirty-one reports (qualitative, quantitative, mixed methods) met the inclusion criteria. Patients deploy diverse strategies across five domains: medication management, symptom monitoring, adjustment of daily activities, fluid and weight management, and lifestyle modification. Social support is pivotal. Many patients deviate from recommendations to balance demands, gaining short-term relief at the potential expense of long-term control. Such deviations function as pragmatic coping and indicate unmet information and structural needs. DISCUSSION: Patients' behaviours are integral to symptom management and should inform context-sensitive professional support and care. Involving family members and utilising digital tools could enhance monitoring, decision-making, and quality of life. Future work should apply Dodd's Symptom Management Model to clarify links between symptom experience, strategies, and outcomes and to develop approaches feasible and compatible with daily life. PATIENT OR PUBLIC CONTRIBUTION: After completing the core scoping review work, we conducted a PPIE session with a person living with heart failure (NYHA III) to validate the category system, the presentation of results, and practice implications. The feedback enhanced interpretability (micro-level strategies) and supported a destigmatising view of non-recommended behaviours.