title: Feasibility and acceptability of a nursing intervention with family caregiver on self-care among heart failure patients: a randomized pilot trial.
abstract: BACKGROUND
  Self-care practices in heart failure (HF) contribute to quality of life, symptom stabilization, and extended life expectancy. However, adherence to practices such as liquid and salt restriction or symptom monitoring require high motivation on a daily basis. The aim was to assess the feasibility, acceptability, and potential effectiveness of a nursing intervention with family caregivers, aimed at improving self-care practice of HF patients.
  
  
  METHODS
  This pilot study involved 32 HF patient-caregiver dyads (16/group) randomized to an experimental (EG) or control group (CG). The intervention, based on the Self-Determination Theory, was designed to enhance patients' autonomy and motivation in self-care practices, by involving their caregivers' support. Five encounters were planned with the EG dyads-two face-to-face during hospitalization and three by telephone after discharge. The feasibility of delivering the protocol was evaluated as well as the acceptability of the intervention. The potential effectiveness of the intervention was assessed based on patient outcomes, including general self-care management and self-care specific to HF, perceived competence to manage HF, autonomous motivation (A-motivation, external extrinsic motivation, internal extrinsic motivation, and intrinsic motivation), and perceived support from the caregiver. Caregiver outcomes included level of support provided to the patient.
  
  
  RESULTS
  Despite recruitment challenges, the intervention was feasible, with 12 of the 16 dyads receiving all 5 encounters delivered per protocol. The 4 other dyads received the two hospital encounters, but at least 1 of the 3 post-discharge planned telephone encounters was not feasible because the patients had been re-hospitalized or was deceased. Participant's satisfaction with the intervention was high. Outcomes favoring the EG include self-care specific to HF, internal extrinsic motivation, intrinsic motivation, and caregiver's feeling that they provide a higher level of support.
  
  
  CONCLUSIONS
  Caregiver involvement was found to be both a feasible and acceptable means of supporting self-care practice in HF patients. This approach presents a potential avenue for enhancing patients' efforts in this regard. However, this pilot study offers preliminary findings only, which need to be replicated in a phase 3 clinical trial.
authors.affiliation: Faculty of Nursing, University of Montreal, Montreal Heart Institute Research Center S-2510, 5000 Belanger Street, Montreal, Quebec H1T 1C8 Canada.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Cossette
authors.affiliation: Heart Failure Clinic, Montreal Heart Institute Research Center S-2490, 5000 Belanger Street, Montreal, Quebec H1T 1C8 Canada.
authors.forename: Hayet
authors.initials: H
authors.lastname: Belaid
authors.affiliation: Montreal Heart Institute, 5000 Belanger Street, Montreal, Quebec H1T 1C8 Canada.
authors.forename: Sonia
authors.initials: S
authors.lastname: Heppell
authors.affiliation: Heart Failure Clinic, Montreal Heart Institute Research Center S-2490, 5000 Belanger Street, Montreal, Quebec H1T 1C8 Canada.
authors.forename: Tanya
authors.initials: T
authors.lastname: Mailhot
authors.affiliation: Montreal Health Innovations Coordinating Center, Suite 400, 4100 Rue Molson, Montréal, Québec H1Y 3N1 Canada.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Guertin
keywords: Family caregiver; Heart failure; Nursing intervention; Self-Determination Theory; Self-care