Jiang Ying, Shorey Shefaly, Nguyen Hoang D, Wu Vivien Xi, Lee Choy Yee, Yang Lee Fung, Koh Karen Wei Ling, Wang Wenru
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
School of Computing Science, University of Glasgow.
Eur J Cardiovasc Nurs. 2020 Mar;19(3):212-222. doi: 10.1177/1474515119872853. Epub 2019 Sep 5.
Chronic heart failure (CHF) is one of the most common causes of hospital admissions and readmissions. Managing CHF requires a comprehensive treatment plan that consists of medication treatment and behavioural change. However, patients often feel unprepared for their self-management role in the community, especially during the period of transition after discharge from hospital. Therefore, an effective intervention to promote CHF self-management is needed.
This paper describes the development and pilot testing of a multicomponent nursing intervention (i.e. the HOM-HEMP) for a randomised controlled trial to assess its effectiveness in improving self-care behaviour among CHF patients in Singapore. A description of the study intervention is also delineated in detail.
The HOM-HEMP was developed based on the UK Medical Research Council framework for developing and evaluating complex interventions. After the development of the study intervention, a single group pre- and post-repeated measure pilot test was conducted to evaluate the study intervention package for its acceptability and the feasibility of the data collection procedure. Ten participants were recruited through consecutive sampling. All of the participants received the full intervention package with the supplementary mobile application. The data were collected at baseline and immediately after the study intervention (i.e. 6 weeks from baseline). The outcome measures included the Self-Care Heart Failure Index, Cardiac Self-Efficacy Scale, Minnesota Living with Heart Failure Questionnaire, Hospital Anxiety and Depression Scale and Short Form of the Social Support Questionnaire.
The results from the pilot testing showed that the programme was feasible and potentially effective in improving patient's self-care management, psychological outcomes and health-related quality of life.
A self-management psychosocial education approach is the preferred choice for many patients with chronic diseases. The effectiveness of the HOM-HEMP will next be tested in a full scale randomised control trial.
慢性心力衰竭（CHF）是住院和再入院的最常见原因之一。管理CHF需要一个综合治疗计划，包括药物治疗和行为改变。然而，患者往往对自己在社区中的自我管理角色感到没有准备，特别是在出院后的过渡期间。因此，需要一种有效的干预措施来促进CHF的自我管理。
本文描述了一项多成分护理干预措施（即HOM-HEMP）的开发和试点测试，该干预措施用于一项随机对照试验，以评估其在改善新加坡CHF患者自我护理行为方面的有效性。还详细描述了研究干预措施。
HOM-HEMP是根据英国医学研究理事会制定和评估复杂干预措施的框架开发的。在研究干预措施开发完成后，进行了单组前后重复测量试点测试，以评估研究干预措施包的可接受性和数据收集程序的可行性。通过连续抽样招募了10名参与者。所有参与者都接受了完整的干预措施包以及补充移动应用程序。在基线时和研究干预措施结束后（即从基线起6周）收集数据。结果测量包括自我护理心力衰竭指数、心脏自我效能量表、明尼苏达心力衰竭生活问卷、医院焦虑和抑郁量表以及社会支持问卷简表。
试点测试结果表明，该方案在改善患者自我护理管理、心理结果和健康相关生活质量方面是可行的且可能有效。
自我管理心理社会教育方法是许多慢性病患者的首选。HOM-HEMP的有效性接下来将在一项全面的随机对照试验中进行测试。
