Factors Influencing Home‑based Volume Management in Patients with Chronic Heart Failure: A Qualitative Meta‑synthesis Based on COM‑B Model

Abstract Background Home-based volume management of patients with chronic heart failure (CHF) is influenced by multiple factors. Grounded in the COM-B model, this study explores relevant influencing factors across three dimensions: capability, opportunity and motivation, and provides evidence for developing home-based volume management intervention programs for CHF patients. Methods A systematic literature search across PubMed, Cochrane Library, Embase, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), Wanfang Databases from inception to June 30th, 2026. Eligible studies were extracted and thematically summarized and analyzed. Results A total of 18 studies were included. Thirty‑two research findings were extracted, which were ultimately synthesized into 13 categories and synthesized into six integrated results: psychological capability (volume management knowledge and skills, cognitive dysfunction); physical capability (frailty, physical discomfort caused by volume management); reflective motivation (volume overload perception, self‑efficacy); automatic motivation (habits and impulses, emotional drivers); physical opportunity (environmental constraints and support, re-source accessibility); and social opportunity (family, hospital, peers). Conclusions Home‑based volume management behavior in CHF patients is influenced by the interactive effects of capability, opportunity, and motivation. The identification of the "opportunity‑capability‑behavior" enhancing pathway provides new targets for intervention. When developing intervention studies for home‑based volume management in CHF patients, nursing teams should fully consider the dynamic relationships among these three dimensions and develop multidimensional, individualized nursing intervention programs.