Division of General Internal Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
J Card Fail. 2011 Oct;17(10):789-96. doi: 10.1016/j.cardfail.2011.06.374. Epub 2011 Jul 23.
The optimal strategy for promoting self-care for heart failure (HF) is unclear.
We conducted a randomized trial to determine whether a "teach to goal" (TTG) educational and behavioral support program provided incremental benefits to a brief (1 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 to 8 telephone counseling sessions over 1 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 < .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 < .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 < .001 for the difference in change scores). Improvements were similar regardless of participants' literacy level.
Telephone reinforcement of learning goals and self-care behaviors improved knowledge, health behaviors, and HF-related QOL compared to a single education session.
促进心力衰竭（HF）自我护理的最佳策略仍不明确。
我们开展了一项随机试验，旨在确定“以目标为导向的教学”（TTG）教育和行为支持计划是否为知识、自我护理行为和 HF 相关生活质量（HFQOL）的简短（1 小时）教育干预（BEI）提供了额外的益处。TTG 计划教授使用调整剂量的利尿剂，然后通过 1 个月内的 5 到 8 次电话咨询课程来强化学习目标和行为。参与者（n=605）的平均年龄为 61 岁；37%的人有边缘性或不充分的读写能力；69%的人射血分数<0.45；31%的人有 III 或 IV 级症状。TTG 组在一般和盐知识方面有更大的改善（P<0.001），自我护理行为的增加更多（从 TTG 的 4.8 到 7.6，而 BEI 的 5.2 到 6.7；P<0.001）。HFQOL 从 TTG 组的 58.5 提高到 64.6，但 BEI 组没有变化（变化分数的差异 P<0.001）。无论参与者的读写能力水平如何，改善情况都相似。
与单次教育课程相比，电话强化学习目标和自我护理行为可提高知识、健康行为和 HF 相关的生活质量。
