College of Nursing & Research Institute of Nursing Science, Seoul National University, Seoul, South Korea.
College of Nursing & Research Institute of Nursing Science, Seoul National University, Seoul, South Korea.
Patient Educ Couns. 2022 Aug;105(8):2740-2746. doi: 10.1016/j.pec.2022.03.022. Epub 2022 Mar 29.
To examine the effects of an educational intervention on patient-reported outcomes and all-cause mortality in heart failure (HF) patients METHODS: In this randomized controlled trial, we enrolled 122 hospitalized patients with HF. The intervention group (n = 60) received an individual nurse-led education session on HF self-management during hospitalization and three telephone calls after discharge. The control group (n = 62) received care as usual. Patient-reported outcomes were measured at baseline and at 3 and 6 months. Mortality status was determined using the National Death Records. Intervention effects were evaluated using the Cox proportional hazards regression model and linear mixed models.
During the follow-up (median: 568 days), 7 deaths (12%) in the intervention group and 15 deaths (24%) in the control group occurred (adjusted hazard ratio, 0.40; 95% confidence interval, 0.16-0.98; P = .046). From baseline to 3 and 6 months, the intervention group showed greater improvements in HF knowledge (difference=6.14, P = .03; difference=5.76, P = .02, respectively), self-care (difference=-6.08, P < .001; difference=-6.16, P < .001, respectively), and health-related quality of life (difference=-11.90, P = .01; difference=-14.57, P = .004, respectively) than the control group.
Educational intervention with telephone follow-up reduced all-cause mortality and improved patient-reported outcomes.
Educational intervention should be considered as part of routine care for HF patients.
探讨教育干预对心力衰竭（HF）患者报告结局和全因死亡率的影响。
这是一项随机对照试验，共纳入 122 例住院 HF 患者。干预组（n=60）在住院期间接受了一次由护士主导的 HF 自我管理教育，出院后进行了 3 次电话随访。对照组（n=62）接受常规护理。在基线、3 个月和 6 个月时测量患者报告的结局。通过国家死亡记录确定死亡率。使用 Cox 比例风险回归模型和线性混合模型评估干预效果。
在随访期间（中位数：568 天），干预组发生 7 例死亡（12%），对照组发生 15 例死亡（24%）（调整后的危险比，0.40；95%置信区间，0.16-0.98；P=0.046）。从基线到 3 个月和 6 个月，干预组 HF 知识（差值=6.14，P=0.03；差值=5.76，P=0.02，分别）、自我护理（差值=-6.08，P<0.001；差值=-6.16，P<0.001，分别）和健康相关生活质量（差值=-11.90，P=0.01；差值=-14.57，P=0.004，分别）的改善均优于对照组。
带电话随访的教育干预可降低全因死亡率并改善患者报告的结局。
教育干预应被视为 HF 患者常规护理的一部分。
