The Effectiveness of a Pre-Discharge Educational Program on Promoting One-Year Clinical Outcomes in Patients with Heart Failure

Abstract

Background: Patient education is important to promote self-care in patients with heart failure. Objective: The purpose of this study was to test a nurse-led pre-discharge patient educational program on promoting self-care, quality of life, depression, sleep disturbances, and heart failure-related rehospitalizations in patients with heart failure over one-year period after hospital discharge. Methods: A quasi-experimental research design with a convenience sampling was used. A 42-page pamphlet with large font size and pictorial format was developed as the teaching material. Participants were recruited from two medical centers located in southern Taiwan with 34 participants were assigned to the experimental group and 35 to the control group. After completing the questionnaires at baseline, the experimental group received a pre-discharge education session and telephone follow-ups or outpatient follow-ups. The control group received the usual hospital discharge teaching only. Post tests were done one month, 3 months, 6 months, and 12 months after both groups were discharged. Generalized estimation equation analyses were used to examine the changes over time between the two groups. Results: The results showed that no statistical differences were found in demographic data, heart failure characteristics, and any major variable scores between the two groups at the baseline. The intervention group showed significant improvements in self-care maintenance and self-care management, but not for quality of life, sleep disturbances, and depression at the end of the study. Although a significant difference was not detected, the intervention group had fewer readmission events than the control group (10 vs. 27). Conclusion: The study supports the effectiveness of the patient education program on promoting self-care maintenance and management in patients with heart failure during the one-year period after discharge from hospital. The study findings can be served as a reference for healthcare providers and researchers to promote self-care and conduct research studies in people with heart failure.