The chronic disabling condition of heart failure (HF) affects nearly 5 million people in the U.S., causing profoundly distressing symptoms such as severe shortness of breath (dyspnea) and decreased quality of life. As many as 20 million Americans are likely to develop HF in the next 1-5 years, thus the disease is reaching epidemic proportions. Repeated emergency room visits and rehospitalizations for symptom relief contribute to the fact that HF is the most expensive Medicare and hospital discharge diagnosis for people over 65. Reasons for readmissions include delays in symptom recognition, dietary noncompliance, medication errors, and lack of knowledge for competent self-care which are common in HF. Cognitive impairments and memory deficits contribute to the challenge of self-management. In the proposed randomized trial, a 6-month educational support intervention will include innovative strategies to enhance memory skills of the participants, eight-modules of content in the intervention, and provide a health promotion approach to self care behaviors. The modules include content on nutrition, medications, memory enhancement, sleep and rest needs, exercise/physical activity, stress management, lifestyle adjustments, and symptom management.
Specific aims are to (1) examine the effects of an educational support intervention for older adults with Class l-lll HF over 4 measurement periods (baseline, immediately after the 3 month educational intervention, after 3 months of phone and/or e-mail support, and at 3 months post-intervention) on health status outcomes (self-perceived health status, emotional state, functional status, memory function, and physiologic variables) and self-care outcomes (knowledge and knowledge retention, self-care ability, health system utilization, symptomatology); and (2) explore participants' subjective perceptions of the usefulness of the intervention. Data analysis will include linear mixed model analyses (hierarchical linear models) to compare the outcomes for the intervention and control groups over time and content analysis for qualitative data.
| Clark, Angela P; McDougall, Graham; Riegel, Barbara et al. (2015) Health Status and Self-care Outcomes After an Education-Support Intervention for People With Chronic Heart Failure. J Cardiovasc Nurs 30:S3-13 |
| Clark, Angela P; McDougall Jr, Graham J; Joiner-Rogers, Glenda et al. (2012) Explanatory models of heart failure etiology. Dimens Crit Care Nurs 31:46-52 |
