Effects of education based on teach-back methods on self‑care and quality of life of the patients with heart failure: a systematic review

Abstract

Background: The role of nurses in educating patients with heart failure is crucial. To ensure effective nursing education, it is vital to integrate new strategies, especially for chronic diseases. The teach-back method (TBM) provides a fresh approach to engaging with patients, effectively overcoming communication barriers, and enhancing long-term educational outcomes.

Objective: The objective of this study was to analyze how the implementation of the teach-back method influences the self-care and quality of life of patients living with heart failure.

Methods: The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) checklist. To ensure thoroughness, an extensive search was carried out across multiple online databases, including PubMed, Web of Science, EMBASE, Scopus, Cochrane Library, CINAHL, and ProQuest. The search spanned from 2000 to August 2023 and employed Medical Subject Headings (MESH) as the basis for keyword selection. No limitations were placed on the language of the studies included in this review. We ensured the inclusion of all relevant articles by searching the gray literature and checking reference lists. Studies which conducted on adults aged ≥ 18 years and diagnosed with heart failure who were not critically ill, receiving dialysis, and waiting for cardiac device implantation was included. We considered all interventional studies. Two reviewers had independently conducted the risk of bias assessment using Cochrane tools. Finally, a narrative synthesis was implemented.

Results: The preliminary search conducted in the databases mentioned above yielded a total of 1702 results. After meticulously going through the steps of study selection, a total of 9 studies involving 768 participants were ultimately chosen to be part of this study. Self-care was the subject of investigation in six studies, whereas quality of life was examined in three studies. The majority of studies indicate that the intervention under consideration had a significant impact on self-care. In relation to quality of life, one study failed to achieve statistically significant outcomes, potentially owing to its small sample size.

Conclusion: Our systematic review demonstrated that the teach-back method, as an innovative educational technique, holds potential for heart failure patients` education and counseling.

Practical value: The teach-back approach confirms patient understanding. Patient understanding is confirmed through rephrasing the information in their own words.

Protocol registration: The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) at the National Institute for Health Research (No: CRD42023446142).

Keywords: Education; Heart failure; Quality of life; Self care; Teach-back.

Fig. 1

PRISMA flowchart for study selection process

Fig. 2

Risk of bias graph of the included RCT studies

Fig. 3

Risk of bias summary of the included RCT studies

Fig. 4

Risk of bias graph of the included non-Randomized studies

Fig. 5

Risk of bias summary of the included non-Randomized studies

Fig. 6

A schematic of how to perform TBM considering 5 Ts