Effectiveness of Nurse-Led Heart Failure Self-Care Education on Health Outcomes of Heart Failure Patients: A Systematic Review and Meta-Analysis

Abstract

Poor self-care behaviors can lead to an increase in the risk of adverse health outcomes among patients with heart failure. Although a number of studies have investigated the effectiveness of nurse-led self-care education, the evidence regarding the effects of nurse-led intervention in heart failure remains uncertain. This study aimed to evaluate evidence on the effectiveness of nurse-led heart failure self-care education on health outcomes in patients with heart failure. To identify studies testing nurse-led education designed to improve self-care among heart failure patients, comprehensive search methods were used between January 2000 and October 2019 to systematically search six electronic databases: PubMed, CINAHL, Embase, Cochrane library, Web of Science, and SCOPUS. All the eligible study data elements were independently assessed and analyzed using random-effects meta-analysis methods. Of 612 studies, eight articles were eligible for this study. Nurse-led heart failure self-care education significantly reduced the risk of all-cause readmission (risk ratio (RR) = 0.75, 95% confidence interval (CI) = 0.66–0.85), heart failure specific readmission (RR = 0.60, 95% CI = 0.42–0.85), and all-cause mortality or readmission (RR = 0.71, 95% CI = 0.61–0.82). However, nurse-led heart failure self-care education was not associated with improvements in the quality of life and heart failure knowledge. Studies on the effectiveness of nurse-led heart failure self-care education mostly report only the positive effects on patients’ health outcomes, whereas evidence of the effectiveness of the nurse-led approach is still limited. Therefore, high quality randomized controlled trials with detailed and explicit descriptions on the components of the interventions are needed.

The evidence for pharmacist care in outpatients with heart failure: a systematic review and meta‐analysis

“… 25 , 28 Cooperation between pharmacists and HF nurses would provide comprehensive patient education and combine their often complementary skills. 36 , 39 For both occupational groups there is evidence that their interventions in HF patients improve clinical outcomes, 12 , 13 , 52 , 53 thus complementary effects could be expected.…”

Clinical value of pulmonary congestion detection by lung ultrasound in patients with chronic heart failure

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Intervenção educativa para o autocuidado de adultos com insuficiência cardíaca: estudo piloto

“…Intervenções que utilizaram tecnologia simples, com suporte estruturado, foram mais eficazes para o autocuidado. (Oyanguren et al, 2016;Kalogirou et al, 2020;Son et al, 2020a).…”

“…Cinco revisões demonstraram efeito positivo das intervenções no conhecimento sobre a IC (Buck et al, 2018;Peng et al, 2019;Hickman et al, 2020;Sokalski et al, 2020;Zhao et al, 2020). Para o desfecho QVRS, quatro revisões apontaram melhores resultados nos pacientes que participaram de programas educativos para o autocuidado (Kalogirou et al, 2020;Son et al, 2020a;Zhao et al, 2020;Son et al, 2020b).…”

“…Estudos com intervenções lideradas principalmente por enfermeiros tiveram melhores resultados relacionados à diminuição de mortalidade e / ou hospitalização(Kalogirou et al, 2020).Em relação aos desfechos de interesse das revisões incluídas, foram comuns hospitalização por IC e todas as causas, mortalidade por IC e todas as causas, autocuidado, conhecimento e qualidade e vida relacionada à saúde. Quatro revisões observaram efeito positivo da intervenção educativa na redução de hospitalização por IC e todas as causas(Inglis et al, 2015; Oyanguren et al, 2016;Kalogirou et al, 2020;Son et al, 2020a) e três observaram efeito positivo da intervenção educativa na redução da mortalidade por IC e todas as causas…”