title: A randomized controlled trial of self-management programme improves health-related outcomes of older people with heart failure.
abstract: OBJECTIVE
  This paper is a report on the effectiveness of a self-management programme based on the self-efficacy construct, in older people with heart failure.
  
  
  BACKGROUND
  Heart failure is a major health problem worldwide, with high mortality and morbidity, making it a leading cause of hospitalization. Heart failure is associated with a complex set of symptoms that arise from problems in fluid and sodium retention. Hence, managing salt and fluid intake is important and can be enhanced by improving patients' self-efficacy in changing their behaviour.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Heart failure patients attending cardiac clinics in northern Taiwan from October 2006-May 2007 were randomly assigned to two groups: control (n = 46) and intervention (n = 47). The intervention group received a 12-week self-management programme that emphasized self-monitoring of salt/fluid intake and heart failure-related symptoms. Data were collected at baseline as well as 4 and 12 weeks later. Data analysis to test the hypotheses used repeated-measures anova models.
  
  
  RESULTS
  Participants who received the intervention programme had significantly better self-efficacy for salt and fluid control, self-management behaviour and their heart failure-related symptoms were significantly lower than participants in the control group. However, the two groups did not differ significantly in health service use.
  
  
  CONCLUSIONS
  The self-management programme improved self-efficacy for salt and fluid control, self-management behaviours, and decreased heart failure-related symptoms in older Taiwanese outpatients with heart failure. Nursing interventions to improve health-related outcomes for patients with heart failure should emphasize self-efficacy in the self-management of their disease.
authors.affiliation: School of Nursing, College of Medicine, Chang Gung University, Taiwan.
authors.forename: Jung-Hua
authors.initials: JH
authors.lastname: Shao
authors.forename: Anne M
authors.initials: AM
authors.lastname: Chang
authors.forename: Helen
authors.initials: H
authors.lastname: Edwards
authors.forename: Yea-Ing Lotus
authors.initials: YI
authors.lastname: Shyu
authors.forename: Su-Hui
authors.initials: SH
authors.lastname: Chen
mesh_terms: D000368:Aged; D004032:Diet; D005260:Female; D006333:Heart Failure / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D008297:Male; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D013624:Taiwan; D016896:Treatment Outcome
keywords: heart failure; nurse; nursing; older adult; randomized controlled trial; self-efficacy; self-management