title: Increasing self-management skills in heart failure patients: a pilot study.
abstract: Nonadherence to medical treatment among heart failure patients is high and results in frequent exacerbations and premature death. This treatment-only pilot study examined whether a year-long group-based self-management intervention is feasible and improves self-management skills in patients with mild-to-moderate heart failure (ejection fraction < or =40% and New York Heart Association functional class I, II, or III). A total of 31 of 100 recruited patients (31%) agreed to participate. Twenty-six (84%) completed the year-long self-management program. Compared with baseline, the intervention was associated with an increase in overall self-efficacy in practicing self-management skills (p<0.001) and in four of five specific self-management skills. Patients and their group leaders also reported an increase in actual use of self-management skills (p<0.001) and in several psychosocial outcomes. The success of this pilot study suggests the need for a randomized clinical trial to test the efficacy of group-based self-management training on medical outcomes.
authors.affiliation: Department of Preventive Medicine, Rush University Medical Center, Chicago, IL 60612, USA. kristinj@uchicago.edu
authors.forename: Kristin J
authors.initials: KJ
authors.lastname: Flynn
authors.forename: Lynda H
authors.initials: LH
authors.lastname: Powell
authors.forename: Carlos F
authors.initials: CF
authors.lastname: Mendes de Leon
authors.forename: Rocio
authors.initials: R
authors.lastname: Muñoz
authors.forename: Claudia B
authors.initials: CB
authors.lastname: Eaton
authors.forename: Diane L
authors.initials: DL
authors.lastname: Downs
authors.forename: Marc A
authors.initials: MA
authors.lastname: Silver
authors.forename: James E
authors.initials: JE
authors.lastname: Calvin
mesh_terms: D000368:Aged; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D018570:Risk Assessment; D012648:Self Care / Q000379:methods*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012959:Socioeconomic Factors