A constructivist approach to teaching patients with heart failure: results from an intervention study.

Abstract

Despite published guidelines emphasizing the importance of education in the management of heart failure (HF), the most effective method of education remains unknown. The aim of this study was to test the efficacy of constructivist teaching method (CTM) on the patients with HF. This is a single-centre, randomized controlled trial. Patients in the intervention group were educated using the CTM in five phases: orientation, elicitation, restructuring, application, and review. The duration of intervention was 6 months. For the study outcome measures, five questionnaires were used: Atlanta Heart Failure Knowledge Test (AHFK), Minnesota Living with Heart Failure (HMLHFQ), Self-Efficacy for Appropriate Medication Use Scale (SEAMS), European Heart Failure Self-care Behaviour Scale (EHFScBS-9), and Duke Activity Status Index (DASI). A total of 122 adults (83.6% male, mean age ± standard deviation 67.1 ± 12.3 years) were enrolled in the study; 61 in the intervention group and 61 in the control group. At 6 months, the knowledge, the quality of life, the self-efficacy for appropriate medication use, the self-care behaviour, and the activity were improved in both groups but the degree of change was greater in the intervention group as indicated from the results of repeated measurements analysis of variance (P < 0.001). Significantly lower proportion of readmission at hospital at 1 month (8.2% vs. 23%, P = 0.025), and 6 months (13.1% vs. 36.1%, P = 0.003) were found for the intervention group. Training of HF patients through the CTM helps effectively manage the disease while significantly reducing hospital readmissions due to decompensation.