title: Patients with heart failure in primary health care: effects of a nurse-led intervention on health-related quality of life and depression.
abstract: OBJECTIVE
  To determine the effects of a nurse-led intervention designed to improve self-management of patients with heart failure in a primary health care setting regarding health-related quality of life and depression.
  
  
  METHODS
  Patients at eight primary health care centres were screened by the Diagnosis Related Groups registry for the diagnosis of heart failure and eligibility for a cluster randomised study. A total of 153 patients were included (n=78 in the intervention group, 54% males, mean age 79 years, 59% in New York Heart Association class III-IV). The intervention involved patient and family education about heart failure and self-management and monthly telephone follow-up during 12 months by a primary health care nurse.
  
  
  RESULTS
  The effects of the nurse-led intervention were limited. Significant differences were found in the physical dimension measured by the SF-36 health survey, and in depression measured by the Zung Self-rating Depression Scale. In comparison within groups at the 3 and 12-month follow-up, the intervention group significantly maintained their health-related quality of life measured by the SF-36 health survey, and their experience of depression measured by the Zung Self-rating Depression Scale to a greater extent than in the control group, especially among women.
  
  
  CONCLUSIONS
  A nurse-led intervention directed toward patients with heart failure in a primary health care setting resulted in limited effects between the groups, although the physical and mental status were retained during 12 months of follow-up to a greater extent than in the control group.
authors.affiliation: Department of Cardiology, County Hospital Ryhov, Jönköping S-551 85, Sweden. jan.martensson@ltjkpg.se
authors.forename: J
authors.initials: J
authors.lastname: Mårtensson
authors.forename: A
authors.initials: A
authors.lastname: Strömberg
authors.forename: U
authors.initials: U
authors.lastname: Dahlström
authors.forename: J-E
authors.initials: JE
authors.lastname: Karlsson
authors.forename: B
authors.initials: B
authors.lastname: Fridlund
mesh_terms: D000368:Aged; D003863:Depression / Q000451:nursing*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000451:nursing* / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008297:Male; D008499:Medical Records; D009722:Nurse Practitioners; D024802:Nurse's Role; D011320:Primary Health Care; D011788:Quality of Life