The Effect of Progressive, Reinforcing Telephone Education and Counseling Versus Brief Educational Intervention on Knowledge, Self-Care Behaviors and Heart Failure Symptoms

Abstract

Background The optimal strategy for promoting self-care for heart failure (HF) is unclear. Methods and Results We conducted a randomized trial to determine whether a “teach to goal” (TTG) educational and behavioral support program provided incremental benefits to a brief (one hour) educational intervention (BEI) for knowledge, self-care behaviors, and HF-related quality of life (HFQOL). The TTG program taught use of adjusted-dose diuretics and then reinforced learning goals and behaviors with 5-8 telephone counseling sessions over one month. Participants’ (N=605) mean age was 61 years; 37% had marginal or inadequate literacy; 69% had ejection fraction < 0.45; and 31% had class III or IV symptoms. The TTG group had greater improvements in general and salt knowledge (p < 0.001) and greater increases in self-care behaviors (from mean 4.8 to 7.6 for TTG vs. 5.2 to 6.7 for BEI; p<0.001). HFQOL improved from 58.5 to 64.6 for the TTG group but did not change for the BEI group (64.7 to 63.9; p < 0.001 for the difference in change scores). Improvements were similar regardless of participants’ literacy level. Conclusions Telephone reinforcement of learning goals and self-care behaviors improved knowledge, health behaviors, and HF-related QOL compared to a single education session.

Intervenções não farmacológicas para melhor qualidade de vida na insuficiência cardíaca: revisão integrativa

“…Regarding year of publication, nine articles were dated 2012 (15)(16)18,(20)(21)(22)(29)(30)(31) , followed by years 2011 (n=6) (11)(12)(13)17,19,23,33) , 2010 (n=4) de la salud que tratan de personas con insuficiencia cardiaca. Futuras revisiones sistemáticas con meta-análisis son necesarias para identificar las intervenciones más eficaces para mejorar la calidad de vida de estos individuos.…”

“…Regarding year of publication, nine articles were dated 2012 (15)(16)18,(20)(21)(22)(29)(30)(31) , followed by years 2011 (n=6) (11)(12)(13)17,19,23,33) , 2010 (n=4) (24)(25)32,34) , 2013 (n=3) (14,(27)(28) and 2008 (n=1) (26) . The articles were published in General Cardiology journals (12)(13)(16)(17)(18)20,22,(24)(25)(28)(29)(30)(31)(32)34) , followed by General Clinical journals (14)(15)(26)(27)33) . Two articles were published in Nursing journals (19,23) and one was published in a Nutrition journal (21) (Chart 1).…”

“…As for languages, all articles were published in English. The selected studies were performed in the following countries: USA (n=8) (12,15,17,19,(24)(25)(32)(33) , Sweden (n=2) (18,23) , Germany (n=2) (22,34) , Brazil (n=2) (21,26) , Australia (n=2) (28)(29) , United Kingdom (n=2) (14,31) , Italy (n=2) (16,30) , Spain (n=1) (13) , Taiwan (n=1) (19) and Iran (n=1) (27) . Nurses were the professionals performing the interventions in most studies (12,(14)(15)(19)(20)32) .…”

“…Six studies did not describe which professionals performed the interventions (13,(26)(27)(28)(29)34) . In four studies, interventions were performed only by physicians (16)(17)25,33) or physicians working Domingo et al (13) , 2011…”

“…Most studies (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(29)(30)(31)(33)(34) were randomized clinical trials (n=18), followed by two quasi-experimental studies (28,32) . Only one article (27) was a non-randomized clinical trial (4.3%) (Chart 1).…”