A Single-Center, Randomized Controlled Trial to Test the Efficacy of Nurse-Led Motivational Interviewing for Enhancing Self-Care in Adults with Heart Failure

Abstract

Background: The role of nurse-led motivational interviewing (MI) in improving self-care among patients with heart failure (HF) is promising, even if it still requires further empirical evidence to determine its efficacy. For this reason, this study tested its efficacy in enhancing self-care maintenance (primary endpoint), self-care management, and self-care confidence after three months from enrollment in adults with HF compared to usual care, and assessed changes in self-care over follow-up times (3, 6, 9, and 12 months). Methods: A single-center, randomized, controlled, parallel-group, superiority study with two experimental arms and a control group was performed. Allocation was in a 1:1:1 ratio between intervention groups and control. Results: MI was effective in improving self-care maintenance after three months when it was performed only for patients (arm 1) and for the patients–caregivers dyad (arm 2) (respectively, Cohen’s d = 0.92, p-value < 0.001; Cohen’s d = 068, p-value < 0.001). These effects were stable over the one-year follow-up. No effects were observed concerning self-care management, while MI moderately influenced self-care confidence. Conclusions: This study supported the adoption of nurse-led MI in the clinical management of adults with HF.

Use of Motivational Interviewing in Older Patients with Multiple Chronic Conditions and Their Informal Caregivers: A Scoping Review

“…We could not find any study that used MI for informal caregivers to promote changes in the self-care behaviors of patients with MCCs. Most of the research on the use of MI for informal caregivers was conducted on caregivers of patients affected by a single chronic condition, such as heart failure [ 31 , 32 , 33 ] and diabetes [ 34 , 35 ]. These studies suggest that when informal caregivers are involved in MI interventions, patients are more likely to modify their behaviors and patient health outcomes improve.…”

“…MI has also been used for family caregivers to improve child care at home, including interventions aimed at preventing childhood obesity [ 27 ], reducing childhood caries [ 28 ], treating eating disorders [ 29 ] and combatting child vaccination hesitancy [ 30 ]. MI interventions have also been directed at informal caregivers to support self-care behavior changes in patients affected by chronic conditions, such as heart failure [ 31 , 32 , 33 ] and diabetes [ 34 , 35 ].…”