Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Sep;29(17-18):3461-3472.
doi: 10.1111/jocn.15384. Epub 2020 Jul 12.

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

Wan-Tzu Chang  1 , Shan-Tair Wang  2   3 , Chih-Hsin Hsu  4 , Liang-Miin Tsai  5 , Shih-Hung Chan  4 , Hsing-Mei Chen  6
Affiliations
Randomized Controlled Trial

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

Wan-Tzu Chang et al. J Clin Nurs. 2020 Sep.

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.

Keywords: heart failure; illness representation; patient education; self-care behaviours.

PubMed Disclaimer

References

REFERENCES

    1. Ahmad, F. S., Barg, F. K., Bowles, K. H., Alexander, M., Goldberg, L. R., French, B., … Kimmel, S. E. (2016). Comparing perspectives of patients, caregivers, and clinicians on heart failure management. Journal of Cardiac Failure, 22(3), 210-217. https://doi.org/10.1016/j.cardfail.2015.10.011
    1. Albert, N. M., Levy, P., Langlois, E., Nutter, B., Yang, D., Kumar, V. A., … Nykun, E. (2014). Heart failure beliefs and self-care adherence while being treated in an emergency department. The Journal of Emergency Medicine, 46(1), 122-129. https://doi.org/10.1016/j.jemermed.2013.04.060
    1. Albert, N. M., & Zeller, R. A. (2007). Development and testing of the survey of illness beliefs in heart failure tool. Progress in Cardiovascular Nursing, 22(2), 63-71. https://doi.org/10.1111/j.0889-7204.2007.06539.x
    1. Aujla, N., Walker, M., Sprigg, N., Abrams, K., Massey, A., & Vedhara, K. (2016). Can illness beliefs, from the common-sense model, prospectively predict adherence to self-management behaviours? A systematic review and meta-analysis. Psychology & Health, 31(8), 931-958. https://doi.org/10.1080/08870446.2016.1153640
    1. Bueno, H., Ross, J. S., Wang, Y., Chen, J., Vidán, M. T., Normand, S. L. T., … Kosiborod, M. (2010). Trends in length of stay and short-term outcomes among Medicare patients hospitalized for heart failure, 1993-2006. The Journal of the American Medical Association, 303(21), 2141-2147. https://doi.org/10.1001/jama.2010.748

Publication types

LinkOut - more resources