Posttraumatic growth theory as a framework for heart failure self-care intervention design

Background: Heart failure (HF) is a life-altering diagnosis that requires sustained self-care and adherence to complex treatment regimens, yet patients may struggle with the psychological burden of managing a progressive, life-altering illness. Although positive psychological approaches are gaining attention in cardiovascular care, growth-oriented frameworks remain underexplored. Posttraumatic Growth (PTG) theory, which describes positive psychological change emerging through engagement with highly challenging life circumstances, may offer a novel conceptual lens for understanding HF self-care and guiding intervention development. Methods: This paper introduces PTG theory as a novel theoretical lens for understanding psychological adaptation and adherence in HF self-care. By extending PTG, a framework previously unused in HF, to the chronic demands of daily self-care, we propose new explanatory pathways linking growth-oriented processes to potential sustained adherence. To illustrate the framework's applicability, we draw on two selected example cases from a small, early-stage positive psychology program development effort. These illustrative cases informed the development of a proposed PTG-informed conceptual model, CardioWell. Results: The illustrative cases contained examples of processes aligned with all five PTG domains: personal strength, spiritual and existential change, improved relationships, appreciation of life, and new possibilities. These examples suggest how engagement in growth-oriented psychological processes might support coping with the ongoing demands of HF self-care. By identifying psychologically meaningful targets and proposing conceptual pathways linking PTG-related processes to HF self-care, this work provides a strong theoretical foundation for the PTG-informed CardioWell model. Conclusion: This paper advances PTG theory as a novel theoretical lens for understanding psychological adaptation in HF self-care and for guiding the development of growth-oriented interventions. A PTG-informed conceptual model (CardioWell) is presented to illustrate how growth-oriented psychological processes could be targeted in future intervention development. These proposed pathways are exploratory and warrant formal evaluation in future research.