Abstract
Objective: The purpose of this study was to test the efficacy of a heart failure (HF) training program on patients' ability to recognize and respond to changes in HF symptoms. The primary aim was to compare event-free survival at 90days. Methods: A total of 99 HF patients randomized to the HF symptom training intervention or usual care completed instruments about self-care (Self-Care of HF Index) and at baseline and 3months. Demographic, clinical, and comorbidity data were collected by interview and chart review. Time to first event (death or a HF-related hospitalization) was tracked by electronic records and patient interview. Results: The sample was predominately male (67.7%), elderly (67.7yrs±12.1) and Caucasian (88.9%). The intervention group reported more events but the difference was not significantly different (χ2=1.18, p=0.26). There was no difference in survival time between groups (χ2=1.53, p=0.216). In paired t-tests, the intervention group had significantly improved self-care maintenance, management and confidence scores (all p<0.01). The usual care group had significantly improved self-care maintenance and management (both p<0.01). Improvements in self-care maintenance and confidence were higher in the intervention group compared with usual care (18.0 vs. 12.9 points). Conclusions: HF symptom awareness training appeared to have an early but not sustained benefit resulting in no difference in 90-day event-free survival. However, larger improvement in self-care maintenance and confidence scores in the intervention group compared to usual care is promising. Embedding meaningful symptom monitoring strategies in self-care maintenance interventions requires further investigation.
Original language | English (US) |
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Pages (from-to) | 273-280 |
Number of pages | 8 |
Journal | Heart and Lung: Journal of Acute and Critical Care |
Volume | 42 |
Issue number | 4 |
DOIs | |
State | Published - Jul 2013 |
Keywords
- Heart failure
- Patient teaching
- Self-care
- Survival analysis
- Symptoms
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine