Nurse-led self-management group programme for patients with congestive heart failure: randomized controlled trial.
OBJECTIVE
This paper reports on of the effects of the Chronic Disease Self-Management Programme on psychosocial attributes, self-care behaviour and quality of life among congestive heart failure patients who experienced slight to marked limitation of physical activity.


BACKGROUND
Most self-management programmes for congestive heart failure patients emphasize the medical aspects of this chronic condition, without incorporating psychosocial aspects of self-management. The programme has been used with various patient groups, but its effectiveness with congestive heart failure patients when led by pairs of cardiac nurse specialists and peer leaders is unknown.


METHODS
A randomized controlled trial with 12 months of follow-up from start of the programme was conducted with 317 patients. Control group patients (n = 131) received usual care, consisting of regular outpatient checkups. Intervention group patients (n = 186) received usual care and participated in the six-week self-management programme. The programme teaches patients medical, social and emotional self-management skills. Twenty-one classes were conducted in six hospitals in the Netherlands, and data were collected between August 2004 and January 2007.


RESULTS
Directly after the programme, statistically significant effects were found for cognitive symptom management (P < 0.001), self-care behaviour (P = 0.008) and cardiac-specific quality of life (P = 0.005). No effects were found at 6- and 12-month follow-up.


CONCLUSIONS
Further research is necessary to study how long-term effectiveness of the programme with patients with congestive heart failure can be achieved, and how successful adaptations of the programme can be integrated into standard care.
Smeulders
Esther S T F
ES
Department of Health Care and Nursing Science, CAPHRI, Maastricht University, The Netherlands. g.kempen@zw.unimaas.nl
van Haastregt
Jolanda C M
JC
Ambergen
Ton
T
Uszko-Lencer
Nicole H K M
NH
Janssen-Boyne
Josiane J J
JJ
Gorgels
Anton P M
AP
Stoffers
Henri E J H
HE
Lodewijks-van der Bolt
Cara L B
CL
van Eijk
Jacques Th M
JT
Kempen
Gertrudis I J M
GI
D000368:Aged; D016507:Cardiology Service, Hospital; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000451:nursing* / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009426:Netherlands; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D057184:Practice Patterns, Nurses'; D011788:Quality of Life; D012648:Self Care / Q000379:methods / Q000523:psychology*; D020377:Self Efficacy