Inventi Impact: Advanced Nursing

Inventi:han/20746/16

Feasibility and Acceptability of a Nursing Intervention with Family Caregiver on Self-Care among\nHeart Failure Patients: A Randomized Pilot Trial

Background: Self-care practices in heart failure (HF) contribute to quality of life, symptom stabilization, and extended\nlife expectancy. However, adherence to practices such as liquid and salt restriction or symptom monitoring require\nhigh motivation on a daily basis. The aim was to assess the feasibility, acceptability, and potential effectiveness of a\nnursing intervention with family caregivers, aimed at improving self-care practice of HF patients.\nMethods: This pilot study involved 32 HF patient-caregiver dyads (16/group) randomized to an experimental (EG) or\ncontrol group (CG). The intervention, based on the Self-Determination Theory, was designed to enhance patients�\nautonomy and motivation in self-care practices, by involving their caregivers� support. Five encounters were planned\nwith the EG dyads�two face-to-face during hospitalization and three by telephone after discharge. The feasibility of\ndelivering the protocol was evaluated as well as the acceptability of the intervention. The potential effectiveness of the\nintervention was assessed based on patient outcomes, including general self-care management and self-care specific\nto HF, perceived competence to manage HF, autonomous motivation (A-motivation, external extrinsic motivation,\ninternal extrinsic motivation, and intrinsic motivation), and perceived support from the caregiver. Caregiver outcomes\nincluded level of support provided to the patient.\nResults: Despite recruitment challenges, the intervention was feasible, with 12 of the 16 dyads receiving all 5\nencounters delivered per protocol. The 4 other dyads received the two hospital encounters, but at least 1 of\nthe 3 post-discharge planned telephone encounters was not feasible because the patients had been re-hospitalized\nor was deceased. Participant�s satisfaction with the intervention was high. Outcomes favoring the EG include self-care\nspecific to HF, internal extrinsic motivation, intrinsic motivation, and caregiver�s feeling that they provide a higher\nlevel of support.\nConclusions: Caregiver involvement was found to be both a feasible and acceptable means of supporting\nself-care practice in HF patients. This approach presents a potential avenue for enhancing patients� efforts in\nthis regard. However, this pilot study offers preliminary findings only, which need to be replicated in a phase\n3 clinical trial.