en Psychology and Psychiatry Original Article <div style="text-align: justify;"><span style="font-size:12px;"><span style="font-family:Times New Roman;"><b>Background:</b> Heart failure (HF) is a chronic condition requiring effective self-care to improve clinical outcomes and quality of life. Psychological factors such as anxiety and depression, as well as religious attitudes, may influence self-care behaviors, but evidence remains inconsistent. Thus, this study aimed to examine the relationships among self-care, religious attitudes, anxiety, and depression among patients with HF.<br> <b>Methods:</b> This cross-sectional study involved recruiting 114 HF patients through convenience sampling at two educational hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences in Iran in 2023. Participants completed a demographic questionnaire, the European Self-Care Behavior Questionnaire (ESCBQ), the Hospital Anxiety and Depression Scale (HADS), and a Religious Attitude Questionnaire. Data were analyzed using SPSS v.22 running t-tests, one-way ANOVA, Chi-square tests, Pearson correlations, and multiple and simple regression analyses.<br> <b>Results:</b> Participants had a mean age of 55.47&plusmn;13.90 years, and hypertension was the most common comorbidity (15.8%). The mean self-care score was 38.92 &plusmn; 7.86 (moderate level; higher scores indicate poorer self-care). Their anxiety (9.83&plusmn;4.22) and depression (9.61&plusmn;4.75) were at moderate levels, while their religious attitudes averaged 69.05 &plusmn; 10.08. Self-care behaviors were significantly negatively correlated with both anxiety and depression (p<0.05), but not with religious attitude. Multiple regression analysis revealed anxiety as the only independent predictor of self-care (&beta;=0.50, p<0.001).<br> <b>Conclusion</b>: Anxiety is a key determinant of self-care in patients with HF, whereas depression has an indirect effect, and religious attitudes show no significant influence. Interventions focusing on anxiety reduction and psychological support may prove effective in enhancing self-care behaviors and improving clinical outcomes in this population.</span></span></div> Heart failure, Depression, Anxiety, Religious attitude, Self-care 0 0 http://nmj.goums.ac.ir/browse.php?a_code=A-10-2148-2&slc_lang=en&sid=1 Alireza Salar salar293@gmail.com 100319475328460017397 100319475328460017397 No Community Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran Kourosh Zarea kourosh1685@gmail.com 100319475328460017398 100319475328460017398 Yes Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Nahid Kashisaz nahid.kashisaz@gmail.com 100319475328460017399 100319475328460017399 No Student Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Farzaneh Ahmadi Ahmadi-F@ajums.ac.ir 100319475328460017400 100319475328460017400 No Department of Cardiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Samaneh Alinejad samaneh@ihm.edu.au 100319475328460017401 100319475328460017401 No School of Nursing, Institute of Health and Management, Sydney Campus, Australia