Huesken Astrid, Hoffmann Rainer, Ayed Sofien
Department of Cardiology, Angiology and Sleep Medicine, Bonifatius Hospital Lingen, Lingen, Germany.
Int J Nurs Sci. 2021 Mar 9;8(2):161-167. doi: 10.1016/j.ijnss.2021.03.002. eCollection 2021 Apr 10.
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.
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 [EHFScB-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).
After the educational session, the total EHFScB-9 score improved from 24.31 ± 6.98 to 14.94 ± 6.22, and the disease knowledge score improved from 18.03 ± 5.44 to 10.74 ± 4.30 (both < 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, EHFScB-9 score was 17.33 ± 7.23 and knowledge score was 12.34 ± 5.30 (both < 0.001 compared with baseline). No factor was predictive of an insufficient teaching effect.
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.
心力衰竭患者管理指南支持对患者进行强化自我护理教育。本研究旨在评估由合格的心力衰竭护士提供的结构化教育对患者自我护理行为和疾病知识的短期和长期影响。
150名因心力衰竭住院的患者（66±12岁）参加了由心力衰竭护士组织的为期一小时的结构化教育课程。患者在教育课程前一天、教育课程后一天和六个月后完成了一份包含15个问题的问卷（9个问题来自欧洲心力衰竭自我护理行为量表[EHFScB - 9]，6个关于患者的疾病知识）。每个问题的可能回答范围从1（完全同意）到5（完全不同意）。
教育课程后，EHFScB - 9总分从24.31±6.98提高到14.94±6.22，疾病知识得分从18.03±5.44提高到10.74±4.30（均P<0.001）。教育前，各个问题的得分范围从1.26±0.81（遵守药物治疗方案）到3.66±1.58（日常称重习惯）。教育后改善最大的是对体重增加的反应（-2.00±1.57）、每日体重控制（-1.77±1.64）以及对患者心力衰竭病因的知识（-1.53±1.43）。在6个月随访时，EHFScB - 9得分是17.33±7.23，知识得分是12.34±5.30（与基线相比均P<0.001）。没有因素可预测教学效果不佳。
由合格护士主导的教育项目可改善患者的自我护理行为和疾病知识，且在6个月随访时有持续效果。没有患者特征会妨碍开展教育课程。
