Using a self-care management tool to improve self-care and quality of life in patients with congestive heart failure

Abstract

Self-management is a primary goal for multiple chronic diseases and particularly for Congestive Heart Failure (CHF). Currently, treatment for CHF emphasizes relieving symptoms through teaching patients how to better care for themselves. Patients who take an active role in self-care are more independent; feel more able to manage their disease and experience better psychological outcomes. However, the research focused on self care-management intervention in heart failure patients in Egypt is very inadequate. Thus, this study aims to first explore the self-care management learning needs among patients with CHF, then secondly assess the effects of a self-care-management tool on self-care adequacy and quality of life (QOL) among this group of patients and thirdly identify patient opinions regarding the instructional developed tool. The research design encompasses the two designs of descriptive and quasi-experimental pretest-posttest study. A convenient sample of 256 patients with congestive heart disease was employed for the survey group in the assessment phase of the study. From this sample, 30% were then randomly assigned to use the developed instructional tool as the experimental group. Two tools were used for data collection. The first was the Heart Failure Self-Care Management Questionnaire (HFSCMQ) which included two parts: the Self-Care Heart Failure Index which was developed by Riegel et al., in 2009, and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) that was developed by Rector T, in 1986. The second tool was a patient feedback opinionnaire which was developed by the researchers to determine patient’s feedback after using the developed tool. Results for the survey group revealed observed inadequate self-care management as perceived by patients with CHF involving self-care maintenance, self-care management and self-care confidence elements, as well as poor QOL detection. Results for the experimental group showed that the CHF patient’s perceptions about self-care management with its components were improved before and after use of the developed instructional tool in the second and third assessments. As well, the QOL was slightly improved as perceived by them. This proves that the self-care management tool may be effective as a self-learning reference among Egyptian CHF patients. In conclusion, instructional health education materials, particularly for patients with chronic illnesses such as CHF, are essential nursing interventions to improve patient self-care management literacy and the QOL. Furthermore, the planning, developing, and implementing of different health instructional materials for patient teaching has become a necessary scheme for nurses to improve their practice in exploring innovative roles in the health education field and activate these roles in different health specialties.