The Effect of the Teach-Back Method on Knowledge, Performance, Readmission, and Quality of Life in Heart Failure Patients

Abstract

Background. Among chronic diseases, heart failure has always been a serious challenge imposing high costs on health systems and societies. Therefore, nurses should adopt new educational strategies to improve self-care behaviors and reduce the readmissions in heart failure patients. This study aimed to determine the effect of the teach-back method on knowledge, performance, readmission, and quality of life in these patients. Methods. This clinical trial was conducted in patients with heart failure (n = 70) hospitalized in the internal wards of the Baqiyatallah al-Azam Medical Center in Tehran (2019). Routine discharge educations were provided in control patients. Self-care topics were taught to the intervention groups by the teach-back method. A cardiac self-care questionnaire was used to assess the knowledge and practice of patients immediately after intervention and three months after patient discharge. Also, SF-36 was presented to each patient. Readmission(s) and quality of life were followed up by telephone interviews three months after patient discharge. Repeated measures analysis of variance and related post-hoc tests were performed for within-group comparisons before, immediately after, and 3 months after teach-back education. Wilks’ lambda multivariate tests were conducted for simultaneous comparison of quality of life subscales between intervention and control groups. Also, logistic regressions were after controlling for baseline measures and confounders. Results. Findings showed significant improvement in the patients’ knowledge and performance immediately after teach-back education, though this effect was slow in the long term after discharge. Also, the frequency of readmissions decreased and the quality of life (except physical function) increased in the patients through teach-back education. By controlling for the pretest effect, the posttest scores for the relevant components of the quality of life suggested improvement in both intervention and control patients. This improvement in the quality of life was confirmed by controlling for baseline measurements using binary logistic regression analysis. Conclusion. Teach-back education improved patients’ knowledge and performance, readmission frequency, and quality of life.

A qualitative study of nurses’ experiences of self-care counseling in migrant patients with heart failure

“…Some of the nurses in the current study used the teach-back education method to reinforce self-care advice in the patients. Evidence supports the use of the teach-back method to maximize the disease understanding of people with chronic disease and promote their knowledge, adherence, self-efficacy, and self-care skills [ 52 , 53 ]. Use of the teach-back method, in addition to building caring relationship and providing continuity, can be the key to migrant patients’ effective adaptation to self-care management.…”

Investigating the effect of multimedia education in combination with teach-back method on quality of life and cardiac anxiety in patients with heart failure: a randomized clinical trial

“…Also, study of Kola et al show teach-back method increasing the level of knowledge led to promote of self-care behaviors, patient-caregiver self-reporting and quality of life in these patients [ 30 ]. In addition, Tran et al showed that teach-back education caused a longer retention of the information learned and improved the effectiveness of health outcomes [ 36 ].…”

Effectiveness of self-care program on the quality of life in patients with coronary artery disease undergoing cardiac rehabilitation

“…reported that teach-back education methods that offer face-to-face education about the signs and symptoms of heart failure, diet, medication, and exercise can positively affect heart failure patients’ QoL and health literacy as routine discharge educations. [ 42 ]…”