Evaluation of an educational programme for family members of patients living with heart failure: a randomised controlled trial

Authors

  • Caroline Löfvenmark,

    1. Authors:Caroline Löfvenmark, RN, PhD, Clinical Nurse and Lecturer, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine and Sophiahemmet University College; Fredrik Saboonchi, PhD, Senior Lecturer, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Sophiahemmet University College, Red Cross University College and Stockholm University, Stress Research Institute; Magnus Edner, MD, PhD, Associate Professor of Cardiology, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital and Department of Medicine, Karolinska University Hospital, Solna, Stockholm; Ewa Billing, RN, PhD, Associate Professor of Nursing, Department of Medical Sciences, Uppsala University, Uppsala; Anne-Cathrine Mattiasson, RNT, PhD, Professor of Nursing, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital and Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
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  • Fredrik Saboonchi,

    1. Authors:Caroline Löfvenmark, RN, PhD, Clinical Nurse and Lecturer, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine and Sophiahemmet University College; Fredrik Saboonchi, PhD, Senior Lecturer, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Sophiahemmet University College, Red Cross University College and Stockholm University, Stress Research Institute; Magnus Edner, MD, PhD, Associate Professor of Cardiology, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital and Department of Medicine, Karolinska University Hospital, Solna, Stockholm; Ewa Billing, RN, PhD, Associate Professor of Nursing, Department of Medical Sciences, Uppsala University, Uppsala; Anne-Cathrine Mattiasson, RNT, PhD, Professor of Nursing, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital and Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
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  • Magnus Edner,

    1. Authors:Caroline Löfvenmark, RN, PhD, Clinical Nurse and Lecturer, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine and Sophiahemmet University College; Fredrik Saboonchi, PhD, Senior Lecturer, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Sophiahemmet University College, Red Cross University College and Stockholm University, Stress Research Institute; Magnus Edner, MD, PhD, Associate Professor of Cardiology, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital and Department of Medicine, Karolinska University Hospital, Solna, Stockholm; Ewa Billing, RN, PhD, Associate Professor of Nursing, Department of Medical Sciences, Uppsala University, Uppsala; Anne-Cathrine Mattiasson, RNT, PhD, Professor of Nursing, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital and Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
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  • Ewa Billing,

    1. Authors:Caroline Löfvenmark, RN, PhD, Clinical Nurse and Lecturer, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine and Sophiahemmet University College; Fredrik Saboonchi, PhD, Senior Lecturer, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Sophiahemmet University College, Red Cross University College and Stockholm University, Stress Research Institute; Magnus Edner, MD, PhD, Associate Professor of Cardiology, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital and Department of Medicine, Karolinska University Hospital, Solna, Stockholm; Ewa Billing, RN, PhD, Associate Professor of Nursing, Department of Medical Sciences, Uppsala University, Uppsala; Anne-Cathrine Mattiasson, RNT, PhD, Professor of Nursing, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital and Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
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  • Anne-Cathrine Mattiasson

    1. Authors:Caroline Löfvenmark, RN, PhD, Clinical Nurse and Lecturer, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine and Sophiahemmet University College; Fredrik Saboonchi, PhD, Senior Lecturer, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Sophiahemmet University College, Red Cross University College and Stockholm University, Stress Research Institute; Magnus Edner, MD, PhD, Associate Professor of Cardiology, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital and Department of Medicine, Karolinska University Hospital, Solna, Stockholm; Ewa Billing, RN, PhD, Associate Professor of Nursing, Department of Medical Sciences, Uppsala University, Uppsala; Anne-Cathrine Mattiasson, RNT, PhD, Professor of Nursing, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital and Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
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Caroline Löfvenmark, Clinical Nurse and Lecturer, Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine and Sophiahemmet University College, Box 5605, 114 86 Stockholm, Sweden. Telephone: +0046 709 634403.
E-mail:caroline.lofvenmark@shh.se

Abstract

Aims and objectives.  To evaluate the effect of a group-based multi-professional educational programme for family members of patients with chronic heart failure with regard to quality of life, depression and anxiety. The secondary aim was to investigate the impact of social support and sense of coherence on changes in quality of life, anxiety and depression during the period of the study.

Background.  When a person is diagnosed with heart failure, the daily life of the family members is also affected.

Design.  Randomised controlled trial.

Methods.  A total of 128 family members were randomly assigned to participate in a multi-professional educational programme or a control group. Analysis of variance and regression analysis were used.

Results.  There were no significant differences in anxiety, depression or quality of life between the intervention group and control group. Adequacy of social network was the only independent variable that explained levels of anxiety and depression after 12 months beyond baseline levels of anxiety (< 0·001, R2 = 0·35) and depression (p = 0·021, R2 = 0·37). Younger family members were found to have a higher quality of life (< 0·01).

Conclusion.  Improved disease-related knowledge may need to be combined with other target variables to induce desired effects on depression, anxiety and quality of life of family members. Antecedents of depression and anxiety, such as sense of control, may need to be specifically targeted. Our results also suggest that intervention aimed at enhancing social support may be beneficial for family members.

Relevance to clinical practice.  Anxiety and depression did not decrease nor did quality of life improve after the intervention. An educational programme for family members with a component specifically targeting anxiety, depression and quality of life warrants testing. Furthermore, it is important that health care providers understand the influence of social support on anxiety, depression and quality of life when interacting with family members.

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