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Effects of illness representation‐focused patient education on illness representations and self‐care in patients with heart failure: A randomised clinical trial
Author(s) -
Chang WanTzu,
Wang ShanTair,
Hsu ChihHsin,
Tsai LiangMiin,
Chan ShihHung,
Chen HsingMei
Publication year - 2020
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.15384
Subject(s) - medicine , intervention (counseling) , psychological intervention , randomized controlled trial , heart failure , physical therapy , confidence interval , clinical trial , nursing
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.