Abstract 13433: Coping Partnership Intervention Improves Heart Failure Self-Care Confidence and Reduces Unplanned Healthcare Utilization

Abstract

Introduction: Social support and social problem-solving, as coping resources, are related to HF self-care, but interventions which target these resources to enhance HF self-care and reduce unplanned emergency room visits and hospitalizations are lacking. Purpose: To determine the efficacy of a nurse-led telephone coping partnership intervention on HF self-care and unplanned healthcare utilization in patients with HF. Methodology: A 3 group randomized controlled pilot study was conducted with 107 HF patients for 3 months. The 12-week coping intervention ( n = 34) included 1 home visit, weekly telephone calls for month 1, and biweekly calls for months 2 and 3. The attention group ( n = 38) received telephone calls starting at week 2 which followed the same pattern as the intervention group. All groups received usual care, with the control group ( n = 35) receiving usual care only. Characteristics of HF patients were: mean age 61 years; 54.2% male; 54.2% African American; and NYHA I: 8.4%; II: 43.9%; III: 18.7%; IV: 29%. All groups provided data at baseline, 5 weeks, 9 weeks, and 13 weeks. HF self-care was assessed using the Self-Care of Heart Failure Index. Data analysis included descriptive statistics and linear mixed modeling. Results: A total of 64 patients completed the study (18 intervention; 24 attention; 22 control). Three linear mixed models were built, controlling for covariates (e.g., gender, race, marital status, NYHA HF class). No significant effects over time were noted by group for self-care maintenance and self-care management. However, significant effects over time were noted for self-care confidence in the intervention group ( p = .030). Patients in the intervention group also reported fewer emergency room visits at 13 weeks (5.6% versus 8.3 % attention; 27.3% control), as well as fewer hospitalizations (5.6% versus 12.5% attention; 27.3% control). Conclusions: Nurse-led telephone coping partnership interventions that strengthen support and social problem-solving appear to be most effective in improving self-care confidence and in reducing unplanned healthcare utilization in individuals with HF. Future research should explore the influence of other variables (e.g., dyadic relationship) on HF outcomes using telephone coping partnerships.