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Randomized Controlled Trial
. 2023 Oct 19;22(7):709-718.
doi: 10.1093/eurjcn/zvac118.

A randomized trial of a nurse-led educational intervention in patients with heart failure and their caregivers: impact on caregiver outcomes

Maria Thodi  1 , Vasiliki Bistola  1 , Ekaterini Lambrinou  2 , Kalliopi Keramida  1   3 , Petros Nikolopoulos  1 , John Parissis  1   4 , Dimitrios Farmakis  1   5 , Gerasimos Filippatos  1
Affiliations
Randomized Controlled Trial

A randomized trial of a nurse-led educational intervention in patients with heart failure and their caregivers: impact on caregiver outcomes

Maria Thodi et al. Eur J Cardiovasc Nurs. .

Abstract

Aims: Psychoeducational interventions focusing on self-management of heart failure (HF) patients may improve patient health knowledge and reduce hospitalizations, but data regarding the effects on caregiver outcomes are inconclusive.

Methods and results: We conducted a single-centre, randomized controlled study to evaluate the effect of a nurse-led educational intervention in dyads of recently hospitalized HF patients and their caregivers on caregiver burden, feelings of guilt and health-related quality of life (HR-QoL). Dyads were randomized to usual care plus intervention group 1 (IG-1) or 2 (IG-2) or usual care only (control group, CG). Educational sessions in IG-1 and IG-2 were initiated before hospital discharge and continued with combination of home visits and telephone sessions in IG-1, or telephone sessions only in IG-2, delivered on regular intervals for 6 months. Caregiver burden was assessed by Heart Failure Caregiver Questionnaire (HF-CQ v5.0), guilt by Caregiver Guilt Questionnaire (CGQ), and QOL by EuroQol EQ-5D. Fifty-seven patient/caregiver dyads were included: 12 in IG-1, 18 in IG-2, and 27 in CG, of whom 11, 16, and 20, respectively, completed the study. All domains of HF-CQ and CGQ improved in IG-1 and IG-2 at 6 months, whereas deteriorated in CG (all P < 0.01). EQ-5D improved in IG-1 and IG-2 only in visual analogue scale part (P = 0.002), but not in the descriptive part.

Conclusion: A nurse-led, 6-month educational intervention on recently hospitalized HF patients/caregiver dyads, delivered through either combined home visits and telephone sessions or telephone sessions only, reduced caregiver burden and feelings of guilt, with lesser effect on HR-QoL.

Registration: ClinicalTrials.gov: NCT05480969.

Keywords: Caregiver burden; Caregiver guilt; Heart failure education; Patient–caregiver dyads.

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Conflict of interest statement

Conflict of interest: V.B. reported honoraria for lectures or advisory boards from AstraZeneca, Bayer, Boehringer Ingelheim, Novartis, and Pfizer. E.L. reported honoraria from Novartis. J.P. reported honoraria for lectures from Orion Pharma, Pfizer, Servier, Astra, AOP Orphan, and Roche Diagnostics. D.F. reported lecture fees or advisory board fees from Abbott Laboratories, Bayer, Boehringer Ingelheim, Leo, Novartis, and Orion. G.F. reported honoraria from Bayer and Boehringer Ingelheim, committee membership for Medtronic, Vifor Pharma, Amgen, Servier, and Novartis, and grants from the European Commission. All other authors report no conflicts of interest.

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