The Effect of Progressive, Reinforcing Telephone Education and Counseling Versus Brief Educational Intervention on Knowledge, Self-Care Behaviors and Heart Failure Symptoms

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• 作者：David W.  ; Baker MD ; MPH¹ ;   ; ^{dbaker1@nmff.org} ; Darren A.  ; DeWalt MD² ; Dean  ; Schillinger MD³ ; Victoria  ; Hawk² ; Bernice  ; Ruo MD¹ ; Kirsten  ; Bibbins-Domingo MD³ ; Morris  ; Weinberger PhD⁴ ; Aurelia  ; Macabasco-O'Connell RN ; PhD⁵ ; Kathy L.  ; Grady RN ; PhD⁶ ; George M.  ; Holmes PhD² ; Brian  ; Erman MSPharm² ; Kimberly A.  ; Broucksou MSW ; MPA² ; Michael  ; Pignone MD²
• 关键词：Heart failure ; patient education ; counseling ; self-care
• 刊名：Journal of Cardiac Failure
• 出版年：2011
• 出版时间：October 2011
• 年：2011
• 卷：17
• 期：10
• 页码：789-796
• 全文大小：219 K

文摘

Background

The optimal strategy for promoting self-care for heart failure (HF) is unclear.

Methods and Results

We conducted a randomized trial to determine whether a ¡°teach to goal?(TTG) educational and behavioral support program provided incremental benefits to a brief (1 hour) educational intervention (BEI) for knowledge, self-care behaviors, and HF-related quality of life (HFQOL). The TTG program taught use of adjusted-dose diuretics and then reinforced learning goals and behaviors with 5 to 8 telephone counseling sessions over 1 month. Participants' (n?= 605) mean age was 61 years; 37 % had marginal or inadequate literacy; 69 % had ejection fraction <0.45; and 31 % had Class III or IV symptoms. The TTG group had greater improvements in general and salt knowledge (P < .001) and greater increases in self-care behaviors (from mean 4.8 to 7.6 for TTG vs. 5.2 to 6.7 for BEI; P < .001). HFQOL improved from 58.5 to 64.6 for the TTG group but did not change for the BEI group (64.7 to 63.9; P < .001 for the difference in change scores). Improvements were similar regardless of participants' literacy level.

Conclusions

Telephone reinforcement of learning goals and self-care behaviors improved knowledge, health behaviors, and HF-related QOL compared to a single education session.