The Impact of Motivational Interviewing on Self-care and Health-Related Quality of Life in Patients With Chronic Heart Failure

Abstract

BackgroundSelf-care is an integral component of successful chronic heart failure (HF) management. Structured educational programs have already been shown to be effective in improving self-care, but some patients show resistance and little motivation for change.ObjectiveThe objective of this study was to compare efficacy in improving self-care and health-related quality of life (HRQoL) for an educational intervention based on motivational interviewing (MI) compared with a conventional educational intervention.MethodsThis experimental pretest-posttest study with an equivalent historical control group included 93 patients in the intervention group and 93 matched patients in the control group. Participants attended a first visit after HF hospitalization discharge and 6 to 7 follow-up visits during 6 months. The European Heart Failure Self-care Behavior scale and the Minnesota Living with Heart Failure Questionnaire were used to assess self-care and HRQoL, respectively. Data on mortality and hospital readmissions were collected as adverse events.ResultsSelf-care improved significantly more in the MI-based intervention group than in the control group (P = .005). Although both self-care and HRQoL improved in both groups over time (P < .05), there was no significant between-group difference in terms of HRQoL improvement over time (P = .13).ConclusionsOur findings suggest that MI delivered by MI-trained nurses is effective in significantly improving self-care by patients with HF. Nonetheless, further studies are required to evaluate the impact of MI on other outcomes, such as HRQoL and adverse clinical events.

Age as a moderator of motivational interviewing and nondirective client‐centered psychotherapy for alcohol use disorder: An exploratory study

“…It is possible that with adaptations for age, MI may increase its effectiveness among OA. Literature on general psychotherapy with OA (Cook et al, 2005), and specifically on MI, recommends that MI be delivered at a slower pace, with longer and more intensive sessions, and across a longer period of time (e.g., Garcimartín et al, 2022). Such enhancements may have increased MI's effect for OA in this study.…”

Interplay between psychosocial and heart failure related factors may partially explain limitations in self-efficacy in patients with heart failure: Insights from a real-world cohort of 1,123 patients

“…Previous studies have explored non-clinical factors that may be associated with self-care in chronic HF. 12,14,30,31 Heo et al studied 122 patients and found that self-care confidence, the perceived control attitudes and the heart failure knowledge measured with specific scales were related to self-care behaviours. 14 Subsequent studies have showed specifically the association of social support with self-care in patients with heart failure 14,30 .…”

“…Addressing behavioural changes of patients in the setting of chronic complex conditions such as heart failure is not an easy task. 12 Self-care is a complex concept and is influenced by modifiable and non-modifiable determinants. Identify modifiable factors as life habits, weight control, etc.…”

“…Previous research has partially addressed the influence of social support, gender and psychological determinants on the level of self-care. 7,[12][13][14] However, little is known about the importance of individual patient characteristics, including not only clinical but also psychosocial factors in patient self-care. 8,9,15 Moreover, previous studies included a few number of patients, focused in specific heart failure phenotypes (Heart failure with reduced ejection fraction) and did not address psycho-social limitations in a comprehensive manner.…”

“…8,9,15 Moreover, previous studies included a few number of patients, focused in specific heart failure phenotypes (Heart failure with reduced ejection fraction) and did not address psycho-social limitations in a comprehensive manner. 7,[12][13][14] Given the limitations above mentioned, our study was designed to identify the clinical and, particularly, the psycho-social factors independently associated with selfcare in a broad-spectrum cohort of real-world patients with chronic HF. Importantly, we evaluated the influence of heart failure-related clinical and psycho-social factors on self-care (globally and each of the 3 domains) to ascertain their relative contribution that may help to guide interventions in the future aimed to improve self-care behaviours.…”