Effects of illness representation‐focused patient education on illness representations and self‐care in patients with heart failure: A randomised clinical trial

Abstract

Aims and objectives To examine the effect of an illness representation‐focused patient education intervention on illness representations and self‐care behaviours in patients with heart failure 3 months after discharge from the hospital. Background Few intervention studies have examined the effect of illness representation‐focused interventions on illness representations and self‐care in patients with heart failure. Design A randomised clinical trial based on the Consolidated Standard of Reporting Trials—CONSORT 2010—guidelines was employed. The Clinical Trial Registry number is TCTR20190903002. Methods One hundred and seven participants were randomly assigned to 2 groups, and 62 participants (n = 30 in the intervention group and n = 32 in the usual care group) completed the baseline and one‐ and three‐month postdischarge follow‐up assessments. The instruments included the Survey of Illness Beliefs in Heart Failure and the Self‐care of Heart Failure Index. The intervention group received illness representation‐focused patient education while hospitalised and telephone follow‐ups after discharge. Data were analysed with linear mixed‐effects model analysis. Results The 107 participants had a mean age of 62.17 years and a mean left ventricular ejection of 53.03%. At baseline, the two groups tended to have accurate illness beliefs but insufficient self‐care confidence and self‐care maintenance. The analysis showed no significant differences between groups in the illness representation total scores, dimension scores or self‐care maintenance scores but did show a significant difference in the self‐care confidence scores (F = 3.42, p < .05) over the three months. Conclusion The study did not show an effect of the intervention on illness representations or self‐care maintenance behaviours. However, the intervention did maintain participants' self‐care confidence three months after discharge. Relevance to clinical practice It is necessary to conduct long‐term follow‐ups of patients' illness representations, discuss the implementation of self‐care behaviours with patients, enhance patients' self‐care confidence, and involve family members or caregivers in self‐care practices when needed.

Outcomes of nurse‐led telecoaching intervention for patients with heart failure: A systematic review and meta‐analysis of randomised controlled trials

“…The current review results demonstrated that nurse‐led telecoaching effectively enhances self‐care confidence and maintenance of HF patients. This finding fills the gap in previous evidence, which showed the inconsistent effect of nurse‐led telecoaching on self‐care behaviour (Chang et al, 2020; Chen et al, 2018; Yu, Lee, et al, 2015). In this review, nurses promoted self‐care through telecoaching, consisting of education, physical examinations, psychosocial support and symptoms management (Hwang et al, 2020; Yu, Lee, et al, 2015; Yu, Lee, et al, 2015).…”

“…Finally, only a few studies were guided by a theoretical framework, which was considered the unique characteristic of nurse‐led intervention. Several nurse‐led interventions were delivered based on the theoretical framework because of the ability to ensure knowledge transfer effectiveness (Chang et al, 2020; Chen et al, 2018; Dekker et al, 2012; Hsu et al, 2020; Sadeghi Akbari et al, 2019). In future studies, it is warranted to consider these aspects when developing nurse‐led telecoaching.…”

“…For instance, prior trials have demonstrated that compared with the usual care that only involves education for HF awareness at hospital discharge, the nurse‐led telephone follow‐up that consists of education, and disease management, effectively improved patients’ self‐care behaviour (Hwang et al, 2020; Shearer et al, 2007) and QoL (Yu, Lee, et al, 2015; Yu et al, 2015). However, several studies also showed that this approach remains insignificantly impactful on self‐care behaviour (Chang et al, 2020) and QoL (Köberich et al, 2015; Riegel et al, 2006). Such inconclusive findings are deserved for clarification by systematically examine all available evidence.…”

Self‐management and illness perception among cervical cancer patients: A cross‐sectional study

“…Self‐management can reduce treatment‐related side effects and the likelihood of secondary complications (Chou, 2019), so it is important for cervical cancer survivors. Behaviours of self‐management may be influenced by information from past experience and sensations (Chang et al, 2020); therefore, how patients perceive cervical cancer can affect adherence to self‐management.…”

The Relationship Between Self-care Behaviors with Religious Attitudes, Anxiety, and Depression in Patients with Heart Failure

“…Heart failure is associated with various physical and psychological stressors such as pain, lack of health, job loss, sensory deprivation, the feeling of imminent death and leads to varying degrees of psychological reactions such as frustration, fatigue and panic, worthlessness, and anxiety. Depression occurs in the patient [7,8].…”