An integrative review of interventions promoting self-care of patients with heart failure

Authors

  • Susan Barnason,

    1. Authors:Susan Barnason, PhD, RN, FAHA, Professor, University of Nebraska Medical Center, College of Nursing-Lincoln Division; Lani Zimmerman, PhD, RN, FAHA, Professor, University of Nebraska Medical Center, College of Nursing-Lincoln Division; Lufei Young, PhD, RN, Assistant Professor, University of Nebraska Medical Center, College of Nursing-Lincoln Division, Lincoln, NE, USA
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  • Lani Zimmerman,

    1. Authors:Susan Barnason, PhD, RN, FAHA, Professor, University of Nebraska Medical Center, College of Nursing-Lincoln Division; Lani Zimmerman, PhD, RN, FAHA, Professor, University of Nebraska Medical Center, College of Nursing-Lincoln Division; Lufei Young, PhD, RN, Assistant Professor, University of Nebraska Medical Center, College of Nursing-Lincoln Division, Lincoln, NE, USA
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  • Lufei Young

    1. Authors:Susan Barnason, PhD, RN, FAHA, Professor, University of Nebraska Medical Center, College of Nursing-Lincoln Division; Lani Zimmerman, PhD, RN, FAHA, Professor, University of Nebraska Medical Center, College of Nursing-Lincoln Division; Lufei Young, PhD, RN, Assistant Professor, University of Nebraska Medical Center, College of Nursing-Lincoln Division, Lincoln, NE, USA
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Susan Barnason, Professor, College of Nursing-Lincoln Division, STE 131, 1230 ‘O’ Street, PO Box 880220, Lincoln, NE 68588-0220, USA.
Telephone: +1 402 472 7359.
E-mail:sbarnaso@unmc.edu

Abstract

Aim and objective.  To examine the interventions used to improve self-care of heart failure patients. The specific objectives were to examine the efficacy of interventions to improve heart failure self-care (self-maintenance and self-management behaviours) and patient-related factors such as knowledge about heart failure, self-efficacy for heart failure self-care (confidence) and beliefs regarding heart failure self-care.

Background.  Despite the significant advances in the treatment and management of heart failure, there continues to be poor patient outcomes associated with this clinical syndrome.

Design.  An integrative review.

Method.  A search of MEDLINE, PsychINFO, Cochrane data base of clinical trials and the cumulative index of nursing and allied health literature (CINAHL) databases was conducted using 14 search terms for a period from 2000–2010. Hand searching of reference lists and author lists was also conducted. Nineteen eligible self-care intervention studies were included in this review.

Results.  Cognitive–behavioural intervention mechanisms were most frequently used to improve patient’s heart failure self-care. In the majority of the studies, the interventions demonstrated efficacy by improving heart failure patients’ self-care maintenance and management behaviours. Intervention group subjects, in the majority of studies, had significantly higher levels of knowledge pertaining to heart failure and heart failure related self-care.

Relevance to clinical practice.  Based on these findings, there are improved patient outcomes when standard patient education for heart failure is augmented using cognitive–behavioural strategies that include additional evidence-based education and counselling.

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