Heart Failure Research Paper

JAN
ORIGINAL RESEARCH

JOURNAL OF ADVANCED NURSING

A randomized controlled trial of self-management programme improves health-related outcomes of older people with heart failure
Jung-Hua Shao, Anne M. Chang, Helen Edwards, Yea-Ing Lotus Shyu & Su-Hui Chen
Accepted for publication 2 February 2013

Correspondence to Su-Hui Chen: e-mail: [e-mail] Jung-Hua Shao PhD RN Assistant Professor School of Nursing, College of Medicine, Chang Gung University, Taiwan Anne M. Chang PhD RN Professor, Professor of Clinical Nursing School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia Helen Edwards PhD RN OAM Professor, Head of School School of Nursing, Queensland University of Technology, Brisbane, Queensland,
Furthermore, HF is associated with older age and, given the dramatic increase in the population of older people worldwide, the prevalence of HF is increasing among older persons in the United States (American Heart Association 2008) and in Taiwan (Department of Statistics 2006). In Europe, a survey of 24 countries revealed that 24% of patients admitted with confirmed or suspected HF were readmitted to hospital (Clelanda et al. 2003). In fact, HF is one of the leading causes of hospitalization and readmission in the US (American Heart Association 2008). In Taiwan, HF was found to be a leading cause of morbidity and to place a large economic burden on society, particularly as the readmission rate for patients with HF is steadily increasing (Department of Statistics 2006). As HF is a progressive condition, patients often experience a high level of symptom burden (Zambroski et al. 2005) and significant decreases in functional status (American Heart Association 2008). Most HF-related symptoms are greatly influenced by fluid overload with sodium retention, which in turn leads to higher rates of readmission (Welsh et al. 2002). Many of these early readmissions for HF may be preventable with improvements in HF management (Str€mberg et al. o 2003, Sisk et al. 2006). Thus, better efforts are needed to manage and decrease these
The experimental group had higher mean SeSFC scores than the control group at Time 2 and Time 3 (Table 4). HF self-management behaviour Repeated-measures ANOVA showed significant effects for HFSmB over time and group, indicating improvement in the intervention group (Table 3). Post-hoc tests using Scheffe’s adjustment for multiple comparisons found significant differences in mean HFSmB scores between Time 1 and Time 2 (P < 0Á001), and between Time 1 and Time 3 (P < 0Á001), but not between Time 2 and Time 3 (Table 4). The experimental group had lower mean HFSmB scores than the control group at Time 2 and Time 3 (Table 4). Heart failure symptom distress Repeated-measures ANOVA indicated significant effects for HFSD over time and according to group (Table 3). Post-hoc tests using Scheffe’s adjustment for multiple comparisons found significant differences in mean HFSD scores between Time 1 and Time 2 (P < 0Á001), and between Time 1 and Time 3 (P < 0Á001), but not between Time 2 and Time 3 (Table 4). The experimental group had lower mean HFSD scores than the control group at Time 2 and Time 3 (Table 4), indicating improvement for HF symptom distress. Health service use The mean rate of health service use in the experimental group decreased significantly from 1Á36 times at pre-test to 1Á34 times at posttest according to Wilcoxon signed rank test (z = À0Á30, P = 0Á76). The mean rates of health service use in