Persistent effect of nurse-led education on self-care behavior and disease knowledge in heart failure patients

Purpose: The guidelines on the management of patients with heart failure support intensive patient education on self-care. The present study aimed to evaluate the short-term and long-term impacts of a structured education provided by a qualified heart failure nurse on patients’ self-care behavior and disease knowledge.Methods: One hundred fifty patients(66 ± 12 years) hospitalized for heart failure participated in a structured one-hour educational session by a heart failure nurse. Patients completed a questionnaire comprising 15 questions(nine questions from the European Heart Failure Self-Care Behavior Scale[EHFSc B-9] and six on the patients’ disease knowledge) one day before and one day and six months after the educational session. Possible responses for each question ranged from 1(complete agreement) to 5(complete disagreement).Results: After the educational session, the total EHFSc B-9 score improved from 24.31 ± 6.98 to14.94 ± 6.22, and the disease knowledge score improved from 18.03 ± 5.44 to 10.74 ± 4.30(both P < 0.001). Scores for individual questions ranged from 1.26 ± 0.81(adherence to the medication protocol) to 3.66 ± 1.58(everyday weighing habits) before the education. The greatest improvement after education was observed on response to weight gain(-2.00±1.57), daily weight control(-1.77 ± 1.64),and knowledge on the cause of patients’ heart failure(-1.53 ± 1.43). At 6-month follow-up, EHFSc B-9score was 17.33 ± 7.23 and knowledge score was 12.34 ± 5.30(both P < 0.001 compared with baseline).No factor was predictive of an insufficient teaching effect.Conclusions: The educational program led by a qualified nurse improves patients’ self-care behavior and disease knowledge with a persistent effect at 6-month follow-up. There are no patient characteristics which preclude the implementation of an educational session.