Aims
Despite published guidelines emphasizing the importance of education in the management of heart failure (HF), the most effective method of education remains unknown. The aim of this study was to test the efficacy of constructivist teaching method (CTM) on the patients with HF.
Methods and results
This is a single-centre, randomized controlled trial. Patients in the intervention group were educated using the CTM in five phases: orientation, elicitation, restructuring, application, and review. The duration of intervention was 6 months. For the study outcome measures, five questionnaires were used: Atlanta Heart Failure Knowledge Test (AHFK), Minnesota Living with Heart Failure (HMLHFQ), Self-Efficacy for Appropriate Medication Use Scale (SEAMS), European Heart Failure Self-care Behaviour Scale (EHFScBS-9), and Duke Activity Status Index (DASI). A total of 122 adults (83.6% male, mean age ± standard deviation 67.1 ± 12.3 years) were enrolled in the study; 61 in the intervention group and 61 in the control group. At 6 months, the knowledge, the quality of life, the self-efficacy for appropriate medication use, the self-care behaviour, and the activity were improved in both groups but the degree of change was greater in the intervention group as indicated from the results of repeated measurements analysis of variance (P < 0.001). Significantly lower proportion of readmission at hospital at 1 month (8.2% vs. 23%, P = 0.025), and 6 months (13.1% vs. 36.1%, P = 0.003) were found for the intervention group.
Conclusions
Training of HF patients through the CTM helps effectively manage the disease while significantly reducing hospital readmissions due to decompensation.
Background: The management of Heart Failure (HF) is the cornerstone for the appropriate therapy and the knowledge obtained concerning the disease is known to affect self-care behaviours. Aim: The aim was to test the association between self-care management, knowledge, self-efficacy for medication and quality of life in chronic HF patients.Material and Method: A cross-sectional study was conducted and four questionnaires were used: Atlanta Heart Failure Knowledge Test (AHFK), Minnesota Living with Heart Failure (HMLHFQ), Self-Efficacy for Appropriate Medication Use Scale (SEAMS), European Heart Failure Self-care Behaviour Scale (EHFScBS-9). Multiple linear regression analysis was performed to identify independently associated variables with study subscales.Results: The sample consisted of 122 Heart Failure patients (102 men-20 women) with mean age 67.1 years (SD=12.3). Scores on Fluid and sodium management, Physical activity and recognition of deteriorating symptoms were significantly greater as compared with scores on Adhering to recommendations (p<0.001), indicating that the needs concerning Adhering to recommendations were greater. Linear regression analyses showed that score on knowledge-test and New York Heart Association (NYHA) class were predictive of medication adherence factors. Better knowledge was associated with better medication adherence, while worse scores were found in subjects with NYHA class III or IV as compared to those with NYHA class I or II. Additionally, Knowledge and years of Education were associated with Self-care behaviour factors (β=0.44, SE=0.08, p<0.001). Conclusions: Patients at a higher level of HF knowledge show better adherence to the Medication. Self-care behavior and life quality are improved.
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