Abstract: Objective To explore the real-world experience of home volume management behaviors in the elderly patients with chronic heart failure (CHF) using the capacity-opportunity-motivation-behavior (COM-B) theoretical model as a framework, and to inform the development of a personalized home management plan for volume overload in the elderly patients. Methods Purposive sampling was used to conduct semi-structured interviews with 15 elderly CHF patients, and content analysis was applied to analyze the data. Results A total of three themes and nine sub-themes were distilled for volume overload home management behaviors in the elderly patients with CHF. The three themes were capacity, opportunity and motivation. Capacity included three sub-themes as poor symptom perception, lack of or deviated management knowledge and ineffective home management coping; Motivation included three sub-themes as lack of confidence in volume management, poor experience of volume management and low exercise self-efficacy; Opportunity included three sub-themes as hospital support, community support and family support. Conclusions The home management behavior of volume overload in the elderly patients with CHF is affected by multiple factors. It is necessary to expand the educational methods and approaches of volume management to effectively improve the self-decision-making and coping ability of the patients, to pay attention to the adverse experience, to establish positive beliefs, to stimulate the motivation for the behavior of volume management, to optimize the strategy of home volume management, and to strengthen the continuity of hospital-community-family volume management.

Key words: chronic heart failure, COM-B theory, home volume management, volume overload management, qualitative study