A quasi-experimental study examining a nurse-led educational program to improve disease knowledge and self-care for patients with acute decompensated heart failure with reduced ejection fraction

Abstract

Background: Nurse-led education can improve heart failure (HF) knowledge and self-care behaviors, and consequently lead to better patient outcomes.

Objectives: To assess the effectiveness of "The Weak Heart" educational model in enhancing the level of disease knowledge and self-care behaviors among patients hospitalized with acute decompensated heart failure with reduced ejection fraction (HFrEF).

Material and methods: An evidence-based, standardized educational program was implemented for HF patients in Poland. We compared the initial level of HF knowledge - as rated using a self-developed questionnaire and self-care behaviors, evaluated according to the 9-item European Heart Failure Self-care Behavior Scale (9-EHFScBS) - to the results obtained at the 3-month follow-up period with a sample of patients (n = 231) hospitalized with acute decompensated HF (ADHF).

Results: The results showed a significant increase in total score of HF knowledge test depending on the time of measurement (χ2 = 356.526, p < 0.001) and in all individual questions on HF. The significant change of the 9-EHFScBS self-care questionnaire was also found in total score (Z = -7.317, p < 0.001), in all domains: autonomous-based adherence (Z = -5.870, p < 0.001); consulting behavior (Z = -7.238, p < 0.001); provider-based adherence (Z = -4.162; p < 0.001) and in relation to all individual statements except statement 7 ("I eat a low salt diet") and statement 9 ("I exercise regularly"). Within 3 months of hospital discharge, 84% (193 out of 231) of participants visited their primary care physician and 79% (183 out of 231) visited a cardiologist in accordance with their individual treatment plan.

Conclusions: "The Weak Heart" educational model is effective in enhancing the level of HF knowledge and self-care behaviors among patients with decompensation of HFrEF.

Keywords: adherence; cardiology; disease education; disease management; heart failure.