Current status and influencing factors of active health behaviors in patients with chronic heart failure: a cross-sectional study

Background Chronic heart failure (CHF), the terminal outcome and a leading cause of death of various cardiovascular diseases, has become a major global public health challenge. Active health behavior plays a crucial role in the long-term management of CHF; however, studies on active health behaviors in this population remain scarce. This study aimed to investigate the current status of active health behaviors and identify their influencing factors among patients with CHF, so as to provide evidence for developing targeted clinical health management programs. Methods A cross-sectional survey was conducted using convenience sampling among 243 patients with CHF recruited from Zhengzhou Central Hospital between January and April 2026. Participants completed a general information questionnaire, the Chronic Disease Patients’ Active Health Behavior Assessment Scale (CDP-AHBAS), the Treatment Burden Scale for Patients with Chronic Heart Failure (TBQ-CHF), and the Coping and Adaptation Processing Scale-Short Form (CAPS-15). Results The total score of the CDP-AHBAS was 66.38 ± 9.31 (item mean score 3.32 ± 0.47), with subdimension scores as follows: individual health responsibility 14.63 ± 2.81, psychological stress coping 15.86 ± 3.02, interpersonal relationship support 13.83 ± 2.42, exercise behavior 10.23 ± 3.23, and nutritional dietary behavior 11.84 ± 2.15. Multiple linear regression analysis revealed that age, educational level, NYHA functional classification, treatment burden, and coping and adaptation ability were independent influencing factors of active health behaviors ( p < 0.05), jointly explaining 49.4% of the total variance. Conclusion Active health behaviors of patients with CHF were at a moderate level. Healthcare professionals should pay close attention to older adults, less-educated, and severely compromised patients, reduce their treatment burden, and enhance their coping and adaptation ability to promote the development of active health behaviors and improve patient outcomes.