Abstract

Background : Patients with Heart Failure (HF) live with a serious disease, and need long term rehabilitation care. Rehabilitation takes place in the hospital as well as in the primary care setting. Elements in rehabilitation for patients with HF are based on the recommendations from the European Society of Cardiology and focuses on self-care and adherence in general. There are no specific guidelines for primary health care. Focus in this study is when the patient is discharged from the outpatient clinic to a primary care setting. The aim of this study is to test a protocol for individual planning of rehabilitation for HF patients with mild to moderate symptoms and to test the effect of individually prepared rehabilitation plans. Methods : The study design is quasi-experimental. Patients in the control group follow the conventional rehabilitation. For the patients in the intervention group an individual rehabilitation plan was prepared and supplemented with telephone follow up after 4 and 12 weeks. All patients’ health status and self-care behaviors were measured at study inclusion (baseline) and after 4 and 12 weeks. Results : 162 patients were included in the study of which 137 (84.6%) consented to participate. There were no differences in total self-care behavior between the groups at the beginning of the trial ( p = .161). After 4 weeks the total score in the control group was 25.3 and in the intervention group the total score was 22.2 ( p = .049). After 12 weeks the score in the control group was 26.8, which was similar to the score at the beginning of the trial, and in the intervention group the score was 22.6, which gives a difference in total score of 6.2 ( p = .007). Conclusion : A systematic prepared intervention leads to a significant increase in total self-care behavior scores in HF patients

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