scholarly journals Effectiveness of an educational program in nursing in the self-care of patients with heart failure: randomized controlled trial

2012 ◽  
Vol 20 (2) ◽  
pp. 296-306 ◽  
Author(s):  
María de los Ángeles Rodríguez-Gázquez ◽  
Edith Arredondo-Holguín ◽  
Richard Herrera-Cortés
Keyword(s):  
Heart Failure ◽  
Educational Program ◽  
Intervention Group ◽  
Self Care ◽  
Group Versus ◽  
The Self ◽  
Control Group ◽  
Number Needed To Treat ◽  
Randomized Controlled ◽  
Patients With Heart Failure

Unblinded randomized controlled clinical trial to evaluate the effectiveness of an educational program in nursing (educational meetings, home visits, telenursing and a printed book) in the improvement of self-care behaviors in patients with heart failure was evaluated. Thirty-three people participated in the intervention group and thirty in the control group. At the beginning and at the end of the study (ninth month), Nancy Artinian's Heart Failure Self-care Behaviors Scale was applied to assess the level of self-care. 66.0% of the intervention group versus 26.6% of the control group improved the self-care score by at least 20% (p<0.001). The Number Needed to Treat was 2.5. The findings suggest that the educational intervention has beneficial effects on the self-care behaviors of people with heart failure.

scholarly journals Effect of a Smartphone-Based App on the Quality of Life of Patients With Heart Failure: Randomized Controlled Trial

JMIR Nursing ◽  
10.2196/20747 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e20747
Author(s):  
Mahboube Davoudi ◽  
Tahereh Najafi Ghezeljeh ◽  
Farveh Vakilian Aghouee
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Randomized Controlled ◽  
Patients With Heart Failure

Background Patients with heart failure have low quality of life because of physical impairments and advanced clinical symptoms. One of the main goals of caring for patients with heart failure is to improve their quality of life. Objective The aim of this study was to investigate the effect of the use of a smartphone-based app on the quality of life of patients with heart failure. Methods This randomized controlled clinical trial with a control group was conducted from June to October 2018 in an urban hospital. In this study, 120 patients with heart failure hospitalized in cardiac care units were randomly allocated to control and intervention groups. Besides routine care, patients in the intervention group received a smartphone-based app and used it every day for 3 months. Both the groups completed the Minnesota Living with Heart Failure Questionnaire before entering the study and at 3 months after entering the study. Data were analyzed using the SPSS software V.16. Results The groups showed statistically significant differences in the mean scores of quality of life and its dimensions after the intervention, thereby indicating a better quality of life in the intervention group (P<.001). The effect size of the intervention on the quality of life was 1.85 (95% CI 1.41-2.3). Moreover, the groups showed statistically significant differences in the changes in the quality of life scores and its dimensions (P<.001). Conclusions Use of a smartphone-based app can improve the quality of life in patients with heart failure. The results of our study recommend that digital apps be used for improving the management of patients with heart failure. Trial Registration Iranian Registry of Clinical Trials IRCT2017061934647N1; https://www.irct.ir/trial/26434

scholarly journals Impact of Remote Titration Combined With Telemonitoring on the Optimization of Guideline-Directed Medical Therapy for Patients With Heart Failure: Internal Pilot of a Randomized Controlled Trial

JMIR Cardio ◽  
10.2196/21962 ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. e21962
Author(s):  
Veronica Artanian ◽  
Heather J Ross ◽  
Valeria E Rac ◽  
Mary O'Sullivan ◽  
Darshan H Brahmbhatt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pilot Study ◽  
Medical Therapy ◽  
Intervention Group ◽  
Dose Optimization ◽  
Control Group ◽  
Internal Pilot ◽  
Randomized Controlled ◽  
Patients With Heart Failure ◽  
Clinic Visits

Background To improve health outcomes in patients with heart failure, guideline-directed medical therapy (GDMT) should be optimized to target doses. However, GDMT remains underutilized, with less than 25% of patients receiving target doses in clinical practice. Telemonitoring could provide reliable and real-time physiological data for clinical decision support to facilitate remote GDMT titration. Objective This paper aims to present findings from an internal pilot study regarding the effectiveness of remote titration facilitated by telemonitoring. Methods A 2-arm randomized controlled pilot trial comparing remote titration versus standard care in a heart function clinic was conducted. Patients were randomized to undergo remote medication titration facilitated by data from a smartphone-based telemonitoring system or standard titration performed during clinic visits. Results A total of 42 patients with new-onset (10/42, 24%) and existing (32/42, 76%) heart failure and a mean age of 55.29 (SD 11.28) years were randomized between January and June 2019. Within 6 months of enrollment, 86% (18/21) of patients in the intervention group achieved optimal doses versus 48% (10/21) of patients in the control group. The median time to dose optimization was 11.0 weeks for the intervention group versus 18.8 weeks for the control group. The number of in-person visits in the intervention group was 54.5% lower than in the control group. Conclusions The results of this pilot study suggest that remote titration facilitated by telemonitoring has the potential to increase the proportion of patients who achieve optimal GDMT doses, decrease time to dose optimization, and reduce the number of clinic visits. Remote titration may facilitate optimal and efficient titration of patients with heart failure while reducing the burden for patients to attend in-person clinic visits. Trial Registration ClinicalTrials.gov NCT04205513; https://clinicaltrials.gov/ct2/show/NCT04205513 International Registered Report Identifier (IRRID) RR2-10.2196/preprints.19705

scholarly journals Impact of Remote Titration Combined With Telemonitoring on the Optimization of Guideline-Directed Medical Therapy for Patients With Heart Failure: Internal Pilot of a Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Veronica Artanian ◽  
Heather J Ross ◽  
Valeria E Rac ◽  
Mary O'Sullivan ◽  
Darshan H Brahmbhatt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pilot Study ◽  
Medical Therapy ◽  
Intervention Group ◽  
Dose Optimization ◽  
Control Group ◽  
Internal Pilot ◽  
Randomized Controlled ◽  
Patients With Heart Failure ◽  
Clinic Visits

BACKGROUND To improve health outcomes in patients with heart failure, guideline-directed medical therapy (GDMT) should be optimized to target doses. However, GDMT remains underutilized, with less than 25% of patients receiving target doses in clinical practice. Telemonitoring could provide reliable and real-time physiological data for clinical decision support to facilitate remote GDMT titration. OBJECTIVE This paper aims to present findings from an internal pilot study regarding the effectiveness of remote titration facilitated by telemonitoring. METHODS A 2-arm randomized controlled pilot trial comparing remote titration versus standard care in a heart function clinic was conducted. Patients were randomized to undergo remote medication titration facilitated by data from a smartphone-based telemonitoring system or standard titration performed during clinic visits. RESULTS A total of 42 patients with new-onset (10/42, 24%) and existing (32/42, 76%) heart failure and a mean age of 55.29 (SD 11.28) years were randomized between January and June 2019. Within 6 months of enrollment, 86% (18/21) of patients in the intervention group achieved optimal doses versus 48% (10/21) of patients in the control group. The median time to dose optimization was 11.0 weeks for the intervention group versus 18.8 weeks for the control group. The number of in-person visits in the intervention group was 54.5% lower than in the control group. CONCLUSIONS The results of this pilot study suggest that remote titration facilitated by telemonitoring has the potential to increase the proportion of patients who achieve optimal GDMT doses, decrease time to dose optimization, and reduce the number of clinic visits. Remote titration may facilitate optimal and efficient titration of patients with heart failure while reducing the burden for patients to attend in-person clinic visits. CLINICALTRIAL ClinicalTrials.gov NCT04205513; https://clinicaltrials.gov/ct2/show/NCT04205513 INTERNATIONAL REGISTERED REPORT RR2-10.2196/preprints.19705

scholarly journals Effect of a Smartphone-Based App on the Quality of Life of Patients With Heart Failure: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Mahboube Davoudi ◽  
Tahereh Najafi Ghezeljeh ◽  
Farveh Vakilian Aghouee
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Randomized Controlled ◽  
Patients With Heart Failure

BACKGROUND Patients with heart failure have low quality of life because of physical impairments and advanced clinical symptoms. One of the main goals of caring for patients with heart failure is to improve their quality of life. OBJECTIVE The aim of this study was to investigate the effect of the use of a smartphone-based app on the quality of life of patients with heart failure. METHODS This randomized controlled clinical trial with a control group was conducted from June to October 2018 in an urban hospital. In this study, 120 patients with heart failure hospitalized in cardiac care units were randomly allocated to control and intervention groups. Besides routine care, patients in the intervention group received a smartphone-based app and used it every day for 3 months. Both the groups completed the Minnesota Living with Heart Failure Questionnaire before entering the study and at 3 months after entering the study. Data were analyzed using the SPSS software V.16. RESULTS The groups showed statistically significant differences in the mean scores of quality of life and its dimensions after the intervention, thereby indicating a better quality of life in the intervention group (<i>P</i>&lt;.001). The effect size of the intervention on the quality of life was 1.85 (95% CI 1.41-2.3). Moreover, the groups showed statistically significant differences in the changes in the quality of life scores and its dimensions (<i>P</i>&lt;.001). CONCLUSIONS Use of a smartphone-based app can improve the quality of life in patients with heart failure. The results of our study recommend that digital apps be used for improving the management of patients with heart failure. CLINICALTRIAL Iranian Registry of Clinical Trials IRCT2017061934647N1; https://www.irct.ir/trial/26434

scholarly journals The Effect of Teach-Back Training on Self-Care and Readmission of Patients with Heart Failure

2020 ◽  
Vol 9 (3) ◽  
Author(s):  
Hedie Mesbahi ◽  
Fatihe Kermansaravi ◽  
Fatemeh Kiyani
Keyword(s):  
Heart Failure ◽  
Coronary Care Unit ◽  
Intervention Group ◽  
Self Care ◽  
T Test ◽  
Teaching Hospitals ◽  
Control Group ◽  
Patients With Heart Failure ◽  
Care Training ◽  
Coronary Care

Background: Teach-back training is one of the interactive teaching methods that assess the learner's understanding by asking questions and provide a proper educational context for behavior change. Involving patients with heart failure in treatment is a top priority. Objectives: Accordingly, the present study aimed to explore the effect of teach-back training on self-care and readmission of patients with heart failure. Methods: The present quasi-experimental study was conducted on 80 patients with heart failure in the Coronary Care Unit (CCU) and Post Coronary Care Unit (PCCU) of teaching hospitals affiliated to Zahedan University of Medical Sciences in southeastern Iran in 2019. The patients were selected via the convenience sampling method and randomly placed into two intervention and control groups. In the intervention group, self-care training was performed individually using the teach-back method in four sessions, each lasting 30 to 60 minutes. In contrast, the participants in the control group conventionally received self-care training. The instruments used to collect the data were the demographic information form and the European Heart Failure Self Care Behavior (EHFSCB). The EHFSCB was completed by the participants in the two groups in two stages before and three months after the intervention. The number of readmissions and the number of visits to the doctor at the end of the third month after discharge were recorded for all patients by directly asking the patients. The collected data were analyzed using SPSS-22 software, the independent samples t-test, paired-samples t-test, and chi-square test at a significant level of P < 0.05. Results: After three months, the mean scores of total self-care behaviors during the intervention were significantly different between the two groups (P < 0.001). Besides, the average number of readmissions due to heart disease three months after the intervention showed the positive effect of the intervention in reducing readmissions in patients in the intervention group (P = 0.002). Conclusions: This study showed that teach-back training could affect self-care behaviors positively and reduce the number of readmissions of patients with heart failure. Therefore, it is recommended that nurses use this training method to teach self-care behaviors to heart patients.

scholarly journals Effect of Illness Perception Correction - Based Educational Program on Quality Of Life and Self- Care in Patients with Heart Failure: a Randomized Controlled Trial

2019 ◽  
Vol 8 (2) ◽  
pp. 89-93 ◽  
Author(s):  
Ali Sadeghi Akbari ◽  
Mohammad Ali Cheraghi ◽  
Anoushiravan kazemnejad ◽  
Mahin Nomali ◽  
Maasumeh Zakerimoghadam
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Randomized Controlled Trial ◽  
Educational Program ◽  
Controlled Trial ◽  
Illness Perception ◽  
Self Care ◽  
Control Group ◽  
Randomized Controlled

Introduction: Because of the chronic nature of Heart Failure (HF), low Quality of Life (QoL) and poor self-care are prevalent among patients with HF. Thus, the aim of this study was to evaluate the effect of illness perception correction- based educational program on QoL,and self- care in patients with HF. Methods: In this randomized controlled trial, 78 eligible patients were included in the study from Rajaei Heart Center (Tehran, Iran) and randomly assigned into intervention and control group with 1:1 allocation ratio. The intervention was a combination of illness perception correction- based education program (30- minute sessions over 3 consecutive days) and 10-minute phone calls made once a week in the course of 8 weeks. The control group received usual care. The primary outcome was quality of life and secondary outcomes were self- care and illness- perception which were measured at baseline and at the end of the study. SPSS version 13 was used for the analysis. Results: Out of 76 eligible patients, 70 patients with HF finished the study. Although the mean of quality of life, self-care, and illness perception were not different at baseline, QoL (45.2 (8.3) VS 66.8 (15.4); P<0.001), self-care (18.5 (4.5) VS 37.1 (7.2); P<0.001), and illness- perception (183.6 (8.4) VS 151.2 (24.5); P<0.001) improved following the program in the intervention group in comparison to the control group. Conclusion: According to the study findings, this program can be applied by nurses for patients with HF as a discharge plan in order to improve their QoL, self-care, and their illness perception.

scholarly journals Effect of an orientation group for patients with chronic heart failure: randomized controlled trial

2018 ◽  
Vol 25 (0) ◽  
Author(s):  
Cristina Silva Arruda ◽  
Juliana de Melo Vellozo Pereira ◽  
Lyvia da Silva Figueiredo ◽  
Bruna dos Santos Scofano ◽  
Paula Vanessa Peclat Flores ◽  
...  
Keyword(s):  
Heart Failure ◽  
Randomized Controlled Trial ◽  
Chronic Heart Failure ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Adherence To Treatment ◽  
Randomized Controlled ◽  
Orientation Group

ABSTRACT Objective: To evaluate the effect of the orientation group on therapeutic adherence and self-care among patients with chronic heart failure. Method: Randomized controlled trial with 27 patients with chronic heart failure. The intervention group received nursing consultations and participated in group meetings with the multi-professional team. The control group only received nursing consultations in a period of four months. Questionnaires validated for use in Brazil were applied in the beginning and in the end of the study to assess self-care outcomes and adherence to treatment. Categorical variables were expressed through frequency and percentage distributions and the continuous variables through mean and standard deviation. The comparison between the initial and final scores of the intervention and control groups was done through the Student’s t-test. Results: The mean adherence in the intervention group was 13.9 ± 3.6 before the study and 4.8 ± 2.3 after the study. In the control group it was 14.2 ± 3.4 before the study and 14.7 ± 3.5 after the study. The self-care confidence score was lower after the intervention (p=0.01). Conclusion: The orientation group does not improve adherence to treatment and self-care management and maintenance and it may reduce confidence in self-care. Registry REBEC RBR-7r9f2m.

Self-care educational intervention to reduce hospitalisations in heart failure: A randomised controlled trial

2017 ◽  
Vol 17 (2) ◽  
pp. 178-185 ◽  
Author(s):  
M Boyde ◽  
R Peters ◽  
N New ◽  
R Hwang ◽  
T Ha ◽  
...  
Keyword(s):  
Heart Failure ◽  
Randomised Controlled Trial ◽  
Educational Intervention ◽  
Hospital Readmission ◽  
Controlled Trial ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Patients With Heart Failure ◽  
Randomised Controlled

Background: A variety of educational interventions have been implemented to assist patients with heart failure to maintain their own health, develop self-care behaviours and decrease readmissions. Aims: The purpose of this study was to determine the effectiveness of a multimedia educational intervention for patients with heart failure in reducing unplanned hospital readmissions. Methods: The study, a randomised controlled trial in a large tertiary referral hospital in Australia, recruited 200 patients. Patients diagnosed with heart failure were randomly allocated 1:1 to usual education or a multimedia educational intervention. The multimedia approach began with an individual needs assessment to develop an educational plan. The educational intervention included viewing a DVD, and verbal discussion supported by a written manual with a teach-back evaluation strategy. The primary outcome was all-cause unplanned hospital readmission at 28 days, three months and 12 months post-recruitment. The secondary outcomes were changes in knowledge and self-care behaviours at three months and 12 months post-recruitment. Results: At 12 months, data on 171 participants were analysed. There were 24 participants who had an unplanned hospital readmission in the intervention group compared to 44 participants in the control group ( p=0.005). The self-care educational intervention reduced the risk of readmission at 12 months by 30% (relative risk: 0.703; 95% confidence interval: 0.548–0.903). Conclusion: A targeted multimedia educational intervention can be effective in reducing all-cause unplanned readmissions for people with heart failure.

scholarly journals Self-Monitoring by Traffic Light Color Coding Versus Usual Care on Outcomes of Patients With Heart Failure Reduced Ejection Fraction: Protocol for a Randomized Controlled Trial (Preprint)

2017 ◽  
Author(s):  
Mahin Nomali ◽  
Ramin Mohammadrezaei ◽  
Abbas Ali Keshtkar ◽  
Gholamreza Roshandel ◽  
Shahrzad Ghiyasvandian ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Controlled Trial ◽  
Self Care ◽  
The Self ◽  
Control Group ◽  
Traffic Light ◽  
Self Monitoring ◽  
Reduced Ejection Fraction ◽  
Randomized Controlled ◽  
Patients With Heart Failure

BACKGROUND Patients with heart failure (HF) reduced ejection fraction (HFrEF) have symptoms that are more severe and experience a higher rate of hospitalization compared with HF preserved ejection fraction (HFpEF) patients. However, symptom recognition cannot be made by patients based on current approaches. This problem is a barrier to effective self-care that needs to be improved by new self-monitoring instruments and strategies. OBJECTIVE This study describes a protocol for the self-monitoring daily diaries of weight and shortness of breath (SOB) based on the traffic light system (TLS). The primary objective is to compare the self-care between the intervention and control group. Comparison of HF knowledge, HF quality of life (HFQOL), and all-cause hospitalization between the 2 groups are the secondary objectives. METHODS A single-blind randomized controlled trial is being conducted at the HF clinic at Tehran Heart Center (Tehran, Iran). Sixty-eight adult patients of both genders will be enrolled during admission to HF clinic. Eligible subjects will be assigned to either the intervention or control group by a block balanced randomization method. Baseline surveys will be conducted before random allocation. Participants in the intervention group will receive an integrated package consisting of (1) HF self-care education by an Australian Heart Foundation booklet on HF, (2) regular home self-monitoring of weight and SOB, and (3) scheduled call follow-ups for 3 months. Patients in the control group will receive no intervention and they only complete monthly surveys. RESULTS This study is ongoing and is expected to be completed by the end of 2018. CONCLUSIONS This is the first trial with new self-monitoring instruments in Iran as a low and middle-income country. If the findings show a positive effect, the package will be applied in different regions with the same health care status. CLINICALTRIAL Iranian Registry of Clinical Trials IRCT2017021032476N1; https://en.irct.ir/trial/25296?revision=25296 (Archived by WebCite at http://www.webcitation.org/73DLICQL8) INTERNATIONAL REGISTERED REPOR PRR1-10.2196/9209

Effectiveness of an Educational Intervention in Reducing New International Postgraduates’ Acculturative Stress in Malaysian Public Universities: Protocol for a Cluster Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Musheer Abdulwahid Al-Jaberi ◽  
Muhamad Hanafiah Juni ◽  
Hayati Kadir Shahar ◽  
Siti Irma Fadhilah Ismail ◽  
Murad Abdu Saeed ◽  
...  
Keyword(s):  
International Students ◽  
Acculturative Stress ◽  
Educational Program ◽  
Public Universities ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Policy Makers ◽  
Randomized Controlled ◽  
Cluster Randomized

BACKGROUND Universities around the world, including Malaysia, have attracted many international students from different countries. Research has reported that acculturative stress resulting from international students’ attempts to adjust to the cultures of host countries is one of the most challenging issues that affects their lives in general and academic lives in particular. OBJECTIVE This study aims to examine the effectiveness of an educational intervention on acculturative stress among new postgraduate international students joining Malaysian public universities. METHODS A cluster randomized controlled trial design with Malaysian public universities as the unit of randomization will be used in this study. Public universities will be randomized in a 1:1 ratio to be either in the intervention (educational program) or control group (waiting list). Participants in the intervention group will receive 7 sessions in 9 hours delivered by an expert in psychology and the researcher. The control group will receive the intervention once the 3-month follow-up evaluation is completed. RESULTS The data will be analyzed using the generalized estimation equation with a confidence interval value of 95%; significant differences between and within groups are determined as <i>P</i>&lt;.05. The results of the study underlie the effectiveness of educational program in decreasing acculturative stress of new international students and enabling them to cope with a new environment. The results of this study will contribute to previous knowledge of acculturative stress, acculturation, and adjustment of international students. Furthermore, such results are expected to play a role in raising university policy makers’ awareness of their postgraduate international students’ acculturative stress issues and how they can help them avoid such stress and perform well in their academic life. CONCLUSIONS We expect that the intervention group will score significantly lower than the wait-list group on the immediate and 3-month postintervention evaluation of acculturative stress and achieve a higher level of adjustment. Results will have implications for international students, policy makers at universities, the Malaysian Ministry of Higher Education, and future research. CLINICALTRIAL Clinical Trials Registry India CTRI/2018/01/011223; http://ctri.nic.in/Clinicaltrials/showallp.php?mid1= 21978&amp;amp;EncHid=&amp;amp;userName=Muhamad%20Hanafiah%20Juni INTERNATIONAL REGISTERED REPORT PRR1-10.2196/12950

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