Abstract
Nurse-led education can improve heart failure (HF) knowledge and self-care behaviors, and consequently lead to better patient outcomes. To assess the effectiveness of "The Weak Heart" educational model in enhancing the level of disease knowledge and self-care behaviors among patients hospitalized with acute decompensated heart failure with reduced ejection fraction (HFrEF). An evidence-based, standardized educational program was implemented for HF patients in Poland. We compared the initial level of HF knowledge - as rated using a self-developed questionnaire and self-care behaviors, evaluated according to the 9-item European Heart Failure Self-care Behavior Scale (9-EHFScBS) - to the results obtained at the 3-month follow-up period with a sample of patients (n = 231) hospitalized with acute decompensated HF (ADHF). The results showed a significant increase in total score of HF knowledge test depending on the time of measurement (χ2 = 356.526, p < 0.001) and in all individual questions on HF. The significant change of the 9-EHFScBS self-care questionnaire was also found in total score (Z = -7.317, p < 0.001), in all domains: autonomous-based adherence (Z = -5.870, p < 0.001); consulting behavior (Z = -7.238, p < 0.001); provider-based adherence (Z = -4.162; p < 0.001) and in relation to all individual statements except statement 7 ("I eat a low salt diet") and statement 9 ("I exercise regularly"). Within 3 months of hospital discharge, 84% (193 out of 231) of participants visited their primary care physician and 79% (183 out of 231) visited a cardiologist in accordance with their individual treatment plan. "The Weak Heart" educational model is effective in enhancing the level of HF knowledge and self-care behaviors among patients with decompensation of HFrEF.
Highlights
Nurse-led education can improve heart failure (HF) knowledge and self-care behaviors, and lead to better patient outcomes
We compared the initial level of HF knowledge – as rated using a self-developed questionnaire and self-care behaviors, evaluated according to the 9-item European Heart Failure Self-care Behavior Scale (9-EHFScBS) – to the results obtained at the 3-month follow-up period with a sample of patients (n = 231) hospitalized with acute decompensated HF (ADHF)
The significant change of the 9-EHFScBS self-care questionnaire was found in total score (Z = −7.317, p < 0.001), in all domains: autonomous-based adherence (Z = −5.870, p < 0.001); consulting behavior (Z = −7.238, p < 0.001); provider-based adherence (Z = −4.162; p < 0.001) and in relation to all individual statements except statement 7 (“I eat a low salt diet”) and statement 9 (“I exercise regularly”)
Summary
Nurse-led education can improve heart failure (HF) knowledge and self-care behaviors, and lead to better patient outcomes. Heart failure (HF) is an important public health problem, with an estimated prevalence of 1–2% among adults and >10% among people aged >70 years in developing countries.[1] In Poland, over 700,000 patients suffer from HF, which can lead to premature death.[2,3] Heart failure requires multidisciplinary management programs, including self-care education.[1,4,5] self-management interventions often led by nurses are effective at improving knowledge, self-care behaviors, quality of life, and reducing the number of hospitalizations and mortality among patients with HF.[6,7,8,9,10,11,12,13,14,15,16] the active post-discharge monitoring of patients with HF (e.g. via post-discharge phone calls) should translate into better adherence, a reduction in the number of decompensated HF cases and slower disease progression.[1,17].
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