BackgroundPatients with heart failure (HF) reduced ejection fraction (HFrEF) have symptoms that are more severe and experience a higher rate of hospitalization compared with HF preserved ejection fraction (HFpEF) patients. However, symptom recognition cannot be made by patients based on current approaches. This problem is a barrier to effective self-care that needs to be improved by new self-monitoring instruments and strategies.ObjectiveThis study describes a protocol for the self-monitoring daily diaries of weight and shortness of breath (SOB) based on the traffic light system (TLS). The primary objective is to compare the self-care between the intervention and control group. Comparison of HF knowledge, HF quality of life (HFQOL), and all-cause hospitalization between the 2 groups are the secondary objectives.MethodsA single-blind randomized controlled trial is being conducted at the HF clinic at Tehran Heart Center (Tehran, Iran). Sixty-eight adult patients of both genders will be enrolled during admission to HF clinic. Eligible subjects will be assigned to either the intervention or control group by a block balanced randomization method. Baseline surveys will be conducted before random allocation. Participants in the intervention group will receive an integrated package consisting of (1) HF self-care education by an Australian Heart Foundation booklet on HF, (2) regular home self-monitoring of weight and SOB, and (3) scheduled call follow-ups for 3 months. Patients in the control group will receive no intervention and they only complete monthly surveys.ResultsThis study is ongoing and is expected to be completed by the end of 2018.ConclusionsThis is the first trial with new self-monitoring instruments in Iran as a low and middle-income country. If the findings show a positive effect, the package will be applied in different regions with the same health care status.Trial RegistrationIranian Registry of Clinical Trials IRCT2017021032476N1; https://en.irct.ir/trial/25296?revision=25296 (Archived by WebCite at http://www.webcitation.org/73DLICQL8)International Registered Report Identifier (IRRID)PRR1-10.2196/9209

Background: Heart failure (HF) is a serious problem with an increasing prevalence globally. Low level of HF knowledge may cause low compliance and low quality of life and, poor self-care. On the other hand, assessing the level of HF knowledge is necessary in order to apply educational programs. Aims and objectives: the aim was to determine knowledge regarding HF among Iranian patients with HF. Study Design: This was a cross sectional study. Setting: We conducted this study at the HF clinic of Tehran Heart Center (THC) affiliated with Tehran University of Medical Sciences (TUMS, Tehran, Iran). Materials and Methods: In this cross-sectional study, 190 patients older than 18 years old, with confirmed diagnosis of HF for at least 3 months by an HF specialist, NYHA function class II to IV and an ability of reading and writing Farsi language were included during June 2017 and January 2018 by consecutive sampling. Data were gathered in a short form, including demographic and clinical variables. Knowledge regarding HF was measured by the Dutch HF knowledge scale (Cronbach’s alpha=0.62) with 15- multiple choice item. The score range varied between 0 (no knowledge) and 15 (optimum knowledge). Scores were reported totally and in 3 areas of knowledge. Scores higher than the median was considered as higher knowledge. Statistics: The SPSS software version 16 was used to describe data. Normality of continuous variables was checked by the Kolmogorov-Smirnoff test. Frequency and partial frequency distribution were used to describe Categorical variables. While, we used mean, median, standard deviation, and IQR for describing continuous variables. Results: From June 2017 to January 2018, 160/190 patients with median age (IQR) of 59 (16) years old participated in the study (response rate of 84.2%). 67.5% of study patients were male (83.5%). 87.5% of then were married. The majority of patients were with NYHA function class II (60.6%), and with an etiology of ischemic heart disease (65.0%). The median and IQR of total, general, HF treatment, and symptoms/ symptom recognition knowledge were 8 (7-10), 12 (9-14), 2 (1.25-3), and 4 (3-5), respectively. Low level of total, general, HF treatment, and symptoms and symptom recognition knowledge among Iranian patients with HF were 55%, 60%, 58.8%, and 71.9%, respectively. Conclusion: Patients with HF had low levels of total, general, HF treatment, and symptoms/symptom recognition knowledge. Thus, there is an essential need to be improved by an appropriate intervention, especially on knowledge of symptoms /symptom recognition.

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Background: Heart failure (HF) is a major public health with rising prevalence, worldwide. Low health literacy (HL) among patients with HF is associated with clinical outcomes. On the other hand, considering low HL is necessary when designing interventions to improve self-care. Aims and objectives: the aim was to determine functional, communicative and critical HL among Iranian patients with HF. Study Design: This was a cross sectional study. Setting: This study was carried out at the HF clinic of Tehran Heart Center (THC) affiliated with Tehran University of Medical Sciences (TUMS, Tehran, Iran). Materials and Methods: 210 adult patients with confirmed diagnosis of HF for at least 3 months and with NYHA function class II to IV and an ability of reading and writing Farsi language were included in the study during June 2017 and March 2018 with consecutive sampling. Data were collected in a short form that was included demographic and clinical variables which was completed according to patients` self-report and their clinical records. HL was measured by Heart Failure-Specific HL Scale (Cronbach’s alpha=0.71). Scores were reported totally and in 3 domains of functional, communicative, and critical HL. Scores less than the median was considered as low HL. Statistics: Data were described by descriptive statistics such as frequency and partial frequency distribution for categorical variables and mean, median, standard deviation (SD), and interquartile range (IQR) for continuous variables. Results: 188/210 patients with HF participated in the study. The mean age of patients was 59.5 (14.5) years old. The majority of patients were male (64.9%), married (83.5%), and were at the high school level of education (38.4%). In addition, 66.1% of them were employed. The low level of total, functional, communicative, and critical HL was seen among 17%, 54.8%, 60.1%, and 58% of patients with HF. Conclusion: patients with HF had a high level of total HL. While the level of functional, communicative, and critical HL was lower among patients with HF. Thus, there is need to be improved by appropriate intervention.

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