Symptom burden mediates the link between self-reported interoceptive accuracy and self-care in chronic heart failure: a CSM-based cross-sectional study

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ID: 338834
2026
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Ranked #72 of 73 articles by views in european journal of cardiovascular nursing : journal of the working group on cardiovascular nursing of the european society of cardiology

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Abstract
Effective chronic heart failure (CHF) management critically depends on patients’ self-care (maintenance, symptom perception and management).1 Successful self-care begins with the perceived ability to accurately perceive internal bodily signals; when assessed by self-report, this construct is referred to as self-reported interoceptive accuracy (i.e. perceived interoceptive accuracy).2 Guided by the Common-Sense Model of Self-Regulation (CSM),3 self-reported interoceptive accuracy helps transform raw somatic signals into symptom representations, while cumulative distress constitutes symptom burden that guides self-care actions. Although impaired interoception may amplify negative symptom appraisals, direct mediation testing of symptom burden in the self-reported interoceptive accuracy-self-care link remains lacking in CHF. Therefore, this study used the Interoceptive Accuracy Scale (IAS), a self-report instrument measuring perceived interoceptive accuracy, and tested whether symptom burden mediates the relationship between self-reported interoceptive accuracy and self-care dimensions. This cross-sectional study enrolled 353 CHF patients from the Department of Cardiology, First Affiliated Hospital of Soochow University (February–October 2025; Ethics Approval No. 2025-592). Inclusion: age ≥ 18 years, CHF diagnosis per guidelines,4 NYHA class II-IV, and informed consent. The investigation conforms with the principles outlined in the Declaration of Helsinki. Sample size was estimated via Monte Carlo simulation for SEM (power = 0.80, α = 0.05), indicating a minimum required sample of 262; our final sample exceeded this.
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Authors Shulin Zhang, Junhui Li, Xiangyu Wang, Yingnan Zhao, Lei He, Lifen Mao, Rulan Yin, Xiaoqing Shi
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Journal european journal of cardiovascular nursing : journal of the working group on cardiovascular nursing of the european society of cardiology
Year 2026
DOI
10.1093/eurjcn/zvag244
URL
https://doi.org/10.1093/eurjcn/zvag244
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