Multicomponent Home Care Intervention for Older Adults with Heart Failure

2.50
Hdl Handle:
http://hdl.handle.net/10755/299413
Category:
Abstract
Type:
Research Study
Level of Evidence:
Outcomes Research
Research Approach:
Translational Research/Evidence-based Practice
Title:
Multicomponent Home Care Intervention for Older Adults with Heart Failure
Author(s):
Delaney, Colleen
Lead Author STTI Affiliation:
Mu
Author Details:
Colleen Delaney, PhD, RN, AHN-BC; faculty page: http://nursing.uconn.edu/about/faculty-staff/delaney (please cut and paste link into browser)
Abstract:

Summary of Project Aims:  Heart failure (HF) is a chronic, progressive condition that is characterized by poor physiological and psychological outcomes. Older patients who have been referred to home care following hospitalization for HF are a particularly vulnerable group at risk for poor outcomes and high service use. The primary aim of this study was to develop, implement, and test the feasibility and efficacy of the Home care Education, Assessment, Remote-monitoring, and Therapeutic activities” (HEART) trial, a nurse-directed multicomponent home care intervention. Observed outcomes were quality of life (QOL), HF knowledge, and 60-day hospitalization. Specific Aim #1: Determine the efficacy of the HEART intervention on the primary outcome of quality of life (QOL) in persons with HF and on other secondary, health-related outcomes. Specific Aim #2: Provide evidence of the feasibility of the HEART intervention based on knowledge gained and satisfaction expressed by patients and home care nurses.

Theoretical Framework:  The conceptual model of Self-Care in HF provided the conceptual basis for the development of an intervention focused on promoting self-care among community-dwelling elders with HF receiving home care services.

Methods, Procedures and Sampling: 50 patients with a primary diagnosis of HF were assigned to the intervention (n = 26) or control group (n = 24) according to geographical location in a large multi-branch Medicare-certified home health agency. Intervention group patients received 8 structured nurse education visits using evidence-based protocols designed in previous trials to teach HF self-management, as well as a telemonitoring system. Control group patients received usual care and telemonitoring. QOL was assessed using the Minnesota Living with Heart Failure questionnaire. Heart failure knowledge was evaluated with the Dutch Heart failure Knowledge quiz at baseline and 60-day study endpoint.

Summary of Findings: Forty-six patients completed the study (25 in the intervention group and 21 in the control group). Patients participating in the HEART intervention demonstrated significantly improved HF knowledge (F=1.31, p. < .001) in comparison to control group patients’ at the study endpoint. There was a trend toward improved QOL and lower hospital readmission rates (6 patients vs. 9 patients) in the intervention group but this was not statistically significant. Intervention patients reported a high level of satisfaction with the HEART intervention and were willing to engage in a multicomponent intervention in home care to support their health. Home care nurses delivering the intervention reported that the training session and intervention manual were extremely effective in assisting them in organizing the assessment and educational components of the study into their home visits and integrating best-practice protocols in their practice.

Recommendations: Results from this study provide evidence that a nurse-directed multicomponent home care intervention is highly feasible and support further testing to examine the effect of the HEART intervention compared to usual cardiac care in improving health-related outcomes for older home care patients with HF.

Keywords:
heart disease; homecare; self-care; evidence-based practice
MeSH:
Heart Diseases--nursing; Evidence-Based Practice; Home Nursing
Repository Posting Date:
21-Aug-2013
Date of Publication:
21-Aug-2013
Sponsors:
Sigma Theta Tau International
Description:
STTI Research Grant Recipient Abstract Submission
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.; The Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryAbstracten
dc.typeResearch Studyen
dc.evidence.levelOutcomes Researchen
dc.research.approachTranslational Research/Evidence-based Practiceen
dc.titleMulticomponent Home Care Intervention for Older Adults with Heart Failureen_US
dc.contributor.authorDelaney, Colleenen
dc.contributor.departmentMuen
dc.author.detailsColleen Delaney, PhD, RN, AHN-BC; faculty page: http://nursing.uconn.edu/about/faculty-staff/delaney (please cut and paste link into browser)en
dc.identifier.urihttp://hdl.handle.net/10755/299413en
dc.description.abstract<p><strong>Summary of Project Aims</strong>:  Heart failure (HF) is a chronic, progressive condition that is characterized by poor physiological and psychological outcomes. Older patients who have been referred to home care following hospitalization for HF are a particularly vulnerable group at risk for poor outcomes and high service use. The primary aim of this study was to develop, implement, and test the feasibility and efficacy of the Home care Education, Assessment, Remote-monitoring, and Therapeutic activities” (HEART) trial, a nurse-directed multicomponent home care intervention. Observed outcomes were quality of life (QOL), HF knowledge, and 60-day hospitalization. <strong>Specific Aim #1</strong>: Determine the efficacy of the HEART intervention on the primary outcome of quality of life (QOL) in persons with HF and on other secondary, health-related outcomes.<strong> Specific Aim #2:</strong> Provide evidence of the feasibility of the HEART intervention based on knowledge gained and satisfaction expressed by patients and home care nurses.</p> <p><strong>Theoretical Framework</strong>:  The conceptual model of Self-Care in HF<em> </em>provided the conceptual basis for the development of an intervention focused on promoting self-care among community-dwelling elders with HF receiving home care services.</p> <p><strong>Methods, Procedures and Sampling</strong>: 50 patients with a primary diagnosis of HF were assigned to the intervention (n = 26) or control group (n = 24) according to geographical location in a large multi-branch Medicare-certified home health agency. Intervention group patients received 8 structured nurse education visits using evidence-based protocols designed in previous trials to teach HF self-management, as well as a telemonitoring system. Control group patients received usual care and telemonitoring. QOL was assessed using the Minnesota Living with Heart Failure questionnaire. Heart failure knowledge was evaluated with the Dutch Heart failure Knowledge quiz at baseline and 60-day study endpoint.</p> <p><strong>Summary of Findings</strong>: Forty-six patients completed the study (25 in the intervention group and 21 in the control group). Patients participating in the HEART intervention demonstrated significantly improved HF knowledge (F=1.31, p. < .001) in comparison to control group patients’ at the study endpoint. There was a trend toward improved QOL and lower hospital readmission rates (6 patients vs. 9 patients) in the intervention group but this was not statistically significant. Intervention patients reported a high level of satisfaction with the HEART intervention and were willing to engage in a multicomponent intervention in home care to support their health. Home care nurses delivering the intervention reported that the training session and intervention manual were extremely effective in assisting them in organizing the assessment and educational components of the study into their home visits and integrating best-practice protocols in their practice.</p> <p>Recommendations: Results from this study provide evidence that a nurse-directed multicomponent home care intervention is highly feasible and support further testing to examine the effect of the HEART intervention compared to usual cardiac care in improving health-related outcomes for older home care patients with HF.</p>en_GB
dc.subjectheart diseaseen_GB
dc.subjecthomecareen_GB
dc.subjectself-careen_GB
dc.subjectevidence-based practiceen_GB
dc.subject.meshHeart Diseases--nursingen_US
dc.subject.meshEvidence-Based Practiceen_US
dc.subject.meshHome Nursingen
dc.date.available2013-08-21T19:05:35Zen
dc.date.issued2013-08-21en
dc.date.accessioned2013-08-21T19:05:35Zen
dc.description.sponsorshipSigma Theta Tau Internationalen
dc.descriptionSTTI Research Grant Recipient Abstract Submissionen_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item.en
dc.description.noteThe Sigma Theta Tau International grant application that funded this research, in whole or in part, was completed by the applicant and peer-reviewed prior to the award of the STTI grant. No further peer-review has taken place upon the completion of the STTI grant final report and its appearance in this repository.en
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