Original Research
A nurse-led structured education program improves self-management skills and reduces hospital readmissions in patients with chronic heart failure: a randomized and controlled trial in China
AUTHORS
Xiaoning Cui1 Bachelor of Nursing, RN and Director of Nursing
Xiaozhi Zhou2 Bachelor of Nursing, Registered Nurse
Long-le Ma3 MD, Professor of Cardiology and Director of Medical Services
Tong-Wen Sun4 MD, PhD, Professor of Medicine and Director
Lara Bishop5 PhD, Director of Research and Projects
Fergus W Gardiner6 PhD, Manager Research and Policy
Lexin Wang7 MD, PhD, FRACGP, FCSANZ, Professor of Cardiology and Clinical Pharmacology, Honorary Director *
AFFILIATIONS
1, 2, 3 Department of Cardiology, Liaocheng People's Hospital, Liaocheng, Shandong, 252000, China
4 Department of General ICU, the First Affiliated Hospital of Zhengzhou University, Henan Key Laboratory of Critical Care Medicine, Zhengzhou 450052, Henan, China
5, 6 Royal Flying Doctor Service; and The Australian National University, Canberra, ACT 2600, Australia
7 Department of Cardiology, Liaocheng People's Hospital, Liaocheng, Shandong, 252000, China; and School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW 2650, Australia
ACCEPTED: 12 April 2019
early abstract:
Introduction: Patient self-management skills are an important part of heart failure (HF) management. However, there is a lack of knowledge about the effectiveness of nurse-led education on patient self-management and the associated clinical outcomes of rural Chinese patients with chronic heart failure (CHF). As such, this study was designed to evaluate the impact of a nurse-led education program on patient self-management and hospital readmissions in rural patients with CHF.
Methods: Ninety-six patients with CHF were randomly divided into intervention and control groups. A structured education program was delivered to the intervention group during hospitalization and after discharge. Control group patients were managed as per clinical guidelines without structured education. Medication adherence, dietary modifications, social support and symptom control were assessed 12 months after the educational intervention.
Results: The mean score of medication adherence, dietary modifications, social support, and symptom control in the intervention group was higher than in the control group at the end of the study (p <0.01). The readmission rate for HF in the intervention and control group was 10.4% and 27.1%, respectively, p = 0.036.
Conclusions: This study has demonstrated that a structured education program was associated with a significant improvement in medication adherence, dietary modifications, social support and symptom control in rural CHF patients. Furthermore, this program was associated with a significant reduction in hospital readmission. This study indicates that implementation of a nurse-led education program improves self-management and clinical outcomes of rural CHF patients, who may not have regular access to cardiac management services as per metropolitan populations.