title: Educational level and self-care behaviour in patients with heart failure before and after nurse educational intervention.
abstract: BACKGROUND
  Self-care is important for heart failure (HF) management and may be influenced by the patient's educational level.
  
  
  OBJECTIVE
  We assessed the relationship of educational level with baseline self-care behaviour and changes one year after a nursing intervention in HF outpatients attending a HF unit.
  
  
  METHODS
  Three hundred and thirty-five HF patients were studied, with a median age of 67 years (P(25-75) 57-75) and a median HF duration of six months (P(25-75) 1-36). HF aetiology was mainly ischaemic heart disease (53.4%). Median ejection fraction was 30% (P(25-75) 24-37%). The functional class was mainly II (66.3%) and III (25.7%). Educational levels were: very low 17.3%; low 62.1%; medium-high 20.6%. Patients were evaluated at the first visit (baseline) and one year after the educational intervention with the nine-item European Heart Failure Self-care Behaviour Scale.
  
  
  RESULTS
  Median patient scores differed in the baseline (19 (P(25-75) 15-26) vs. 16 (P(25-75) 13-21) vs. 15 (P(25-75) 12.5-15.5)) and the one-year evaluation (15 (P(25-75) 13-17) vs. 13 (P(25-75) 11-15) vs. 12 (P(25-75) 10-14)) for the three educational levels, respectively, with statistically significant differences between levels (p=0.007 to p<0.001) except between low and medium-high education at one year (p=0.057). In the one-year evaluation, self-care behaviour significantly improved in the three educational groups (p<0.001), with a similar, albeit not statistically significant, magnitude of improvement in all groups.
  
  
  CONCLUSIONS
  Self-care behaviour at baseline and one year after a nursing intervention was better in patients with a higher education, although the improvement with the intervention was similar irrespective of the educational level.
authors.affiliation: Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: González
authors.affiliation: Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain Department of Medicine, Universitat Autònoma de Barcelona, Spain jlupon.germanstrias@gencat.cat.
authors.forename: Josep
authors.initials: J
authors.lastname: Lupón
authors.affiliation: Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
authors.forename: Maria del Mar
authors.initials: Mdel M
authors.lastname: Domingo
authors.affiliation: Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
authors.forename: Lucía
authors.initials: L
authors.lastname: Cano
authors.affiliation: Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
authors.forename: Roser
authors.initials: R
authors.lastname: Cabanes
authors.affiliation: Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: de Antonio
authors.affiliation: Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
authors.forename: Miquel
authors.initials: M
authors.lastname: Arenas
authors.affiliation: Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Crespo
authors.affiliation: Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.
authors.forename: Margarita
authors.initials: M
authors.lastname: Rodríguez
authors.affiliation: Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain Department of Medicine, Universitat Autònoma de Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Bayes-Genis
mesh_terms: D000328:Adult; D000368:Aged; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000451:nursing*; D006801:Humans; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D010353:Patient Education as Topic / Q000458:organization & administration*; D011446:Prospective Studies; D012648:Self Care; D011795:Surveys and Questionnaires
keywords: Heart failure; literacy; self-care behaviour