Self-care and improved outcomes: an intervention by heart failure nurse specialists

Journal article


MacInnes, J. and Walton, A. 2016. Self-care and improved outcomes: an intervention by heart failure nurse specialists. British Journal of Cardiac Nursing. 11 (2), pp. 82-88. https://doi.org/10.12968/bjca.2016.11.2.82
AuthorsMacInnes, J. and Walton, A.
Abstract

Background: Heart failure is a prevalent, debilitating condition. Patients need to develop and maintain effective strategies and behaviours to care for themselves and manage their illness.

Aim: The aim of this study was to evaluate whether or not an educational intervention carried out by a team of heart failure nurse specialists (HFNS), as part of usual care, enhanced self-care behaviour in patients with chronic heart failure.

Methods: A quantitative survey was carried out using the ‘Looking After Yourself with Heart Failure Questionnaire (LAYHFQ)’ to determine levels of self-care behaviour pre- and post-HFNS intervention.
All new patients registered to a community heart failure nursing service completed the questionnaire at initial assessment and6 weeks later following the nurse-led intervention (N=36). Paired t-tests (2-tailed) were carried out to determine if there were significant differences between total self-care scores before and after the
intervention, and for each individual self-care behaviour. Results: Self care was improved overall (p=0.011) with five behaviours demonstrating a statistically significant improvement: namely the uptake of flu and
pneumonia vaccination (p=0.009), regular weighing (p=0.001), recognising changes in sleep patterns (p=0.014), recognising signs of fluid retention (p=0.001), and the wellbeing dimension of going out as much as possible (p=0.019).

Conclusion: An educational intervention by an HFNS leads to enhanced self-care and may result in improved physical and psychological outcomes for patients with heart failure.

KeywordsHeart failure Self-care Nurse specialist Intervention Questionnaire
Year2016
JournalBritish Journal of Cardiac Nursing
Journal citation11 (2), pp. 82-88
PublisherMA Healthcare
ISSN1749-6403
Digital Object Identifier (DOI)https://doi.org/10.12968/bjca.2016.11.2.82
Publication dates
Print01 Feb 2016
Publication process dates
Deposited31 Mar 2016
Accepted28 Dec 2015
Output statusPublished
References

Baker DW, Dewalt DA, Schillinger D et al (2011) The effect of progressive, reinforcing telephone education and counseling versus brief educational intervention on knowledge, self-care behaviors and heart failure symptoms. J Card Fail 17(10): 789–96. doi: 10.1016/j.cardfail.2011.06.374

Blue L, Millerick Y (2011) Nonpharmacological management. In: McDonagh TA, Gardner RA, Clark AL, Dargie H, eds. Oxford Textbook of Heart Failure. Oxford University Press, Oxford: 469–78

Department of Health (2006) Supporting people with long-term conditions to Self-Care: A guide to developing local strategies and good practice. DH, London. http://tinyurl.com/kd5zcnv (accessed 21 January 2016)

Heydari A, Ahrari S, Vaghee S (2011) The relationship between selfconcept and adherence to therapeutic regimens in patients with heart failure. J Cardiovasc Nurs 26(6): 475–80. doi: 10.1097/ JCN.0b013e318215bb78

Horowitz CR, Rein SB, Leventhal H (2004) A story of maladies, misconceptions and mishaps: effective management of heart failure. Soc Sci Med 58(3): 631–43

Iqbal J, Francis L, Reid J, Murray S, Denvir M (2010) Quality of life in patients with chronic heart failure and their carers: a 3-year followupstudy assessing hospitalization and mortality. Eur J Heart Fail 12(9): 1002–8. doi: 10.1093/eurjhf/hfq114

Jaarsma T, Strömberg A, Mårtensson J, Dracup K (2003) Development and testing of the European Heart Failure Self-Care Behaviour Scale. Eur J Heart Fail 5(3): 363–70

Jones CD, Holmes GM, Dewalt DA et al (2012) Is adherence to weight monitoring or weight-based diuretic self-adjustment associated with fewer heart failure-related emergency department visits or hospitalizations? J Card Fail 18(7): 576–84. doi: 10.1016/j. cardfail.2012.05.004

Lainscak M, Blue L, Clark AL et al (2011) Self-care management of heart failure: practical recommendations from the Patient Care Committee of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 13(2): 115–26. doi: 10.1093/eurjhf/ hfq219. Epub 2010

Lee CS, Moser DK, Lennie TA, Riegel B (2011) Event-free survival in adults with heart failure who engage in self-care management. Heart Lung 40(1): 12–20. doi: 10.1016/j.hrtlng.2009.12.003. Epub 2010

Macabasco-O’Connell A, DeWalt DA, Broucksou KA et al (2011) Relationship between literacy, knowledge, self-care behaviors, and heart failure-related quality of life among patients with heart failure. J Gen Intern Med 26(9): 979–86. doi: 10.1007/s11606-011-1668-y

MacInnes J (2008) Factors affecting self-care in heart failure: A literature review. British Journal of Cardiac Nursing 3(7): 293–9. doi: 10.12968/bjca.2008.3.7.30495

MacInnes J (2013) Relationships between illness representations, treatment beliefs and the performance of self-care in heart failure: a cross-sectional survey. Eur J Cardiovasc Nurs 12(6): 53 doi:10.1177/1474515112473872

McMurray JJ, Adamopoulos S, Anker SD et al; ESC Committee for Practice Guidelines (2012) ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 33(14): 1787–847. doi: 10.1093/eurheartj/ehs104

Makaya M, Matsuoka S, Kato N (2013) Combination of depression and poor knowledge regarding heart failure: a strong determinant of selfcare behavior in patients with heart failure. Eur Heart J 34(1): 952.doi: 10.1093/eurheartj/eht310.P5130

National Institute for Health and Care Excellence (2010) Chronic heart failure: Management of chronic heart failure in adults in primary and secondary care. [CG5]. NICE, London. https://www.nice.org.uk/guidance/cg5 (accessed 21 January 2016)

Rector TS, Kubo SH, Cohn JN (1987) Patients’ self-assessment of their congestive heart failure. Part 2: Content, reliability and validity of a new measure, the Minnesota Living with Heart Failure questionnaire. Heart Failure Oct/Nov: 198–209

Riegel B, Lee CS, Dickson VV, Carlson B (2009) An update on the selfcare of heart failure index. J Cardiovasc Nurs 24(6): 485–97. doi:10.1097/JCN.0b013e3181b4baa0

Rogers A, Addington-Hall JM, McCoy A et al (2002) A qualitative study of chronic heart failure patients’ understanding of their symptoms and drug therapy. Eur J Heart Fail 4(3): 283–7

Salyer J, Schubert CM, Chiaranai C (2012) Supportive relationships, self-care confidence, and heart failure self-care. J Cardiovasc Nurs 27(5): 384–93. doi: 10.1097/JCN.0b013e31823228cd

Scottish Intercollegiate Guidelines Network (2007) Management of chronic heart failure: A national clinical guideline. SIGN, Edinburgh.
http://www.sign.ac.uk/pdf/sign95.pdf (accessed 21 January 2016)

Shao JH, Chang AM, Edwards H, Shyu YI, Chen SH (2013) A randomized controlled trial of self-management programme improves health-related outcomes of older people with heart failure. J Adv Nurs 69(11): 2458–69. doi: 10.1111/jan.12121

Smeulders ES, van Haastregt JC, Ambergen T, Janssen-Boyne JJ, van Eijk JT, Kempen GI (2009) The impact of a self-management group programme on health behaviour and healthcare utilization among congestive heart failure patients. Eur J Heart Fail 11(6): 609–16. doi:
10.1093/eurjhf/hfp047

Smith H, Hankins M, Hodson A, George C (2009) Measuring the adherence to medication of elderly patients with heart failure: is there a gold standard? Int J Cardiol 145(1): 122–3. doi: 10.1016/j.ijcard.2009.06.031. Epub 2009

Sutherland K (2010) Bridging the quality gap: heart failure. The Health Foundation, London

Permalink -

https://repository.canterbury.ac.uk/item/87qvq/self-care-and-improved-outcomes-an-intervention-by-heart-failure-nurse-specialists

  • 56
    total views
  • 0
    total downloads
  • 1
    views this month
  • 0
    downloads this month

Export as