Effectiveness of Heart Failure Nursing Protocol (HF-NP) on quality of life of patients with heart failure.

BACKGROUND

Effective management of heart failure (HF) requires an integrated approach involving pharmacological and non-pharmacological interventions. Available evidence shows that patients benefit from adjunctive therapies along with guideline-directed medical therapy (GDMT). Still, there is an inadequacy in the use of the best available evidence and the self-management of symptoms by the patients. This study aimed to evaluate the effectiveness of a Heart Failure Nursing Protocol (HF-NP) on selected parameters, that is, symptoms, self-care adequacy, episodes of hospitalizations, depression, exercise capacity, medication adherence, activities of daily living (ADLs), and quality of life (QOL) of the HF patients.

MATERIAL AND METHODS

A pre-experimental study was conducted in a tertiary care hospital in Northern India. A total of 101 patients were enrolled using a convenient sampling technique. Participants were trained individually through demonstrations and educational sessions about self-management of HF at home. An informational booklet was given to all the participants consisting of information about HF, dietary instructions, individual exercise schedules based on the New York Heart Association (NYHA) class, identification of worsening symptoms, daily monitoring of vital parameters, and self-management of HF at home. Telephonic encouragement was provided on day 15, 1 month, and 3 months of baseline visits. The data were checked for normality using the Kolmogorov-Smirnov test and analyzed using a paired -test, Wilcoxon's signed-rank test, and McNemar's test as appropriate.

RESULTS

There was significant improvement in outcomes, such as breathing difficulty ( = 0.028), activity intolerance ( = 0.013), self-care adequacy ( = 0.001), depression ( = 0.001), exercise intensity ( = 0.001), QOL ( = 0.001), and medication adherence ( = 0.001) after 3 months of intervention.

CONCLUSION

HF-NP was effective in improving HF outcomes. It can be used to train patients and their family members regarding the debilitating illness, after doing a large study, and it can be incorporated into the health policy later.