Abstract
Background Among chronic diseases, heart failure has always been a serious challenge imposing high costs on health systems and societies. Therefore, nurses should adopt new educational strategies to improve self-care behaviors and reduce the readmissions in heart failure patients. This study aimed to determine the effect of the teach-back method on knowledge, performance, readmission, and quality of life in these patients. Methods This clinical trial was conducted in patients with heart failure (n = 70) hospitalized in the internal wards of the Baqiyatallah al-Azam Medical Center in Tehran (2019). Routine discharge educations were provided in control patients. Self-care topics were taught to the intervention groups by the teach-back method. A cardiac self-care questionnaire was used to assess the knowledge and practice of patients immediately after intervention and three months after patient discharge. Also, SF-36 was presented to each patient. Readmission(s) and quality of life were followed up by telephone interviews three months after patient discharge. Repeated measures analysis of variance and related post-hoc tests were performed for within-group comparisons before, immediately after, and 3 months after teach-back education. Wilks' lambda multivariate tests were conducted for simultaneous comparison of quality of life subscales between intervention and control groups. Also, logistic regressions were after controlling for baseline measures and confounders. Results Findings showed significant improvement in the patients' knowledge and performance immediately after teach-back education, though this effect was slow in the long term after discharge. Also, the frequency of readmissions decreased and the quality of life (except physical function) increased in the patients through teach-back education. By controlling for the pretest effect, the posttest scores for the relevant components of the quality of life suggested improvement in both intervention and control patients. This improvement in the quality of life was confirmed by controlling for baseline measurements using binary logistic regression analysis. Conclusion Teach-back education improved patients' knowledge and performance, readmission frequency, and quality of life.
Highlights
Chronic disease is a physical or mental condition that persists for more than a year, resulting in functional limitations and a decline in quality of life that requires ongoing monitoring or treatment [1]
Current guidelines indicate that encouraging the patient to self-care is to detect, monitor, and manage disease symptoms, which is an important way to reduce the challenge of rehospitalizing patients [13, 14], reducing symptoms, delaying disease progression, and improving patients’ quality of life [15]. e findings of a systematic review by Sousa et al [16] suggest that heart failure patients are always struggling to balance their self-care needs, but they are often unable to self-manage for their cardiac symptoms [16]. is inability to self-care can affect the quality of life of heart failure patients [17]
The results of analysis of covariance (ANCOVA) showed that the changes in the knowledge after intervention were higher in the intervention group than that of in the control group (P < 0.05) as well as after adjusting for confounders (P < 0.05) (Table 2; Figure 1)
Summary
Heart failure has always been a serious challenge imposing high costs on health systems and societies. erefore, nurses should adopt new educational strategies to improve self-care behaviors and reduce the readmissions in heart failure patients. is study aimed to determine the effect of the teach-back method on knowledge, performance, readmission, and quality of life in these patients. Erefore, nurses should adopt new educational strategies to improve self-care behaviors and reduce the readmissions in heart failure patients. Is study aimed to determine the effect of the teach-back method on knowledge, performance, readmission, and quality of life in these patients. Repeated measures analysis of variance and related post-hoc tests were performed for within-group comparisons before, immediately after, and 3 months after teach-back education. Findings showed significant improvement in the patients’ knowledge and performance immediately after teach-back education, though this effect was slow in the long term after discharge. The frequency of readmissions decreased and the quality of life (except physical function) increased in the patients through teach-back education. Is improvement in the quality of life was confirmed by controlling for baseline measurements using binary logistic regression analysis. Teach-back education improved patients’ knowledge and performance, readmission frequency, and quality of life
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