Self-care and quality of life in patients with advanced heart failure: the effect of a supportive educational intervention.
OBJECTIVE
The goal of this study was to determine the effects of a supportive educational nursing intervention on self-care abilities, self-care behavior, and quality of life of patients with advanced heart failure.


METHODS
The study design was an experimental, random assignment.


METHODS
The study was located at the University Hospital in Maastricht, The Netherlands.


METHODS
The study included 179 patients (mean age 73 years, 58% men, New York Heart Association classification III and IV) admitted to a university hospital with symptoms of heart failure.


METHODS
Outcome measures included self-care abilities (Appraisal of Self-care Agency Scale), self-care behavior (Heart Failure Self-care Behavior Scale), 3 dimensions of quality of life (functional capabilities, symptoms, and psychosocial adjustment to illness), and overall well-being (Cantril's ladder of life).


METHODS
The intervention patients received systematic education and support by a nurse in the hospital and at home. Control patients received routine care.


RESULTS
Self-care abilities did not change as a result of the intervention, but the self-care behavior in the intervention group was higher than the self-care behavior in the control group during follow-up. The effect of the supportive educational intervention on quality of life was limited. The 3 dimensions of quality of life improved after hospitalization in both groups, with no differences between intervention and control group as measured at each follow-up measurement. However, there was a trend indicating differences between the 2 groups in decrease in symptom frequency and symptom distress during the 9 months of follow-up.


CONCLUSIONS
A supportive educational nursing intervention is effective in improving self-care behavior in patients with advanced (New York Heart Association class III-IV) heart failure; however, a more intensive intervention is needed to show effectiveness in improving quality of life.
Jaarsma
T
T
University of Maastricht Department of Nursing Science, Maastricht, The Netherlands.
Halfens
R
R
Tan
F
F
Abu-Saad
H H
HH
Dracup
K
K
Diederiks
J
J
D000223:Adaptation, Psychological; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D011788:Quality of Life; D012648:Self Care; D012720:Severity of Illness Index; D012917:Social Adjustment