Effectiveness of nurse-led program on mental health status and quality of life in patients with chronic heart failure

Abstract

Current study was to evaluate the effectiveness of nurse-led program in improving mental health status (MHS) and quality of life (QOL) in chronic heart failure (CHF) patients after an acute exacerbation. CHF patients were enrolled after informed consent was obtained and were assigned into the control and treatment group. Patients in the control group received standard care. In the treatment group, patients received standard care plus telehealth intervention including inquiring patients medical condition, providing feedbacks, counseling patients, and having positive and emotional talk with patients. At the third and sixth month after discharge, participants were called by registered nurses to assess Mental Health Inventory-5 (MHI-5) and Kansas City Cardiomyopathy Questionnaire (KCCQ) scores. Compared to the treatment group, patients in the control group were less likely to have educational attainment ≥ high school degree and have a married status, but were more likely to have diabetes. No significant differences in MHI-5 (68.5 ± 12.7 vs 66.9 ± 10.4) and KCCQ (70.6 ± 12.2 vs 68.7 ± 10.9) scores at baseline between the control and treatment groups were observed. There were significantly differences in MHI-5 (72.7 ± 15.6 vs 65.2 ± 11.4) and KCCQ score (74.2 ± 14.9 vs 66.4 ± 12.1) at 3 months follow-up between control and treatment groups. Nonetheless, at 6 months follow-up, although MHI-5 and KCCQ scores remained higher in the treatment group, there were no statistically significant differences (MHI-5: 65.4 ± 12.8 vs 61.4 ± 10.0; KCCQ: 65.1 ± 12.3 vs 61.9 ± 10.3). After multivariate regression analysis, not receiving nurse-led program were significantly associated with reduced MHI-5 (odds ratio [OR] 1.25% and 95% confidence interval [CI]: 1.14–1.60) and KCCQ (OR: 1.20% and 95% CI:1.11–1.54) scores. Nurse-led program is helpful to improve MHS and QOL in CHF patients after an acute exacerbation. However, these achievements are attenuated quickly after the nurse-led intervention discontinuation.

Association between the nurse-led program with mental health status, quality of life, and heart failure rehospitalization in chronic heart failure patients

“…Second, compared with the control group, participants in the nurse-led program had lower risk of HF rehospitalization, and after adjusting for potential covariates, the nurse-led program was independently associated with lower odds of HF rehospitalization. Consistent to prior reports, [ 14 – 17 ] findings from the current study support the utilization of the nurse-led program for the management of CHF patients. Further randomized clinical trials are needed to confirm the current findings.…”

“…The performances by registered nurses have been validated in our prior study. [ 14 ] Participants in the control group received standard care (e.g., explanation of disease's condition, the importance of adherence to prescribed medications and low sodium diet, and monitoring body weight daily). In the treatment group, participants received standard care plus telehealth intervention.…”

“…[ 8 – 10 ] Interestingly and importantly, nonpharmacological strategies have been applied to evaluate their effects on QOL and MHS in CHF populations. [ 11 – 14 ] Among these strategies, the nurse-led program has been shown to improve QOL and MHS in these populations for a short period. Specifically, in our prior study, [ 14 ] registered nurses called CHF patients after discharge inquiring their clinical condition, medication adherence, daily sodium consumption, and physical activity.…”

“…[ 11 – 14 ] Among these strategies, the nurse-led program has been shown to improve QOL and MHS in these populations for a short period. Specifically, in our prior study, [ 14 ] registered nurses called CHF patients after discharge inquiring their clinical condition, medication adherence, daily sodium consumption, and physical activity. Based on these evaluations, guidance on selfcare management and persuasive statement regarding medical management were provided.…”

“…Through this strategy, we observed that the QOL and MHS of CHF patients were significantly improved after 6 months’ follow-up. [ 14 ] Other studies also have demonstrated that the nurse-led program was beneficial for lowering the risks of HF rehospitalization and unplanned admission. [ 15 – 17 ]…”