Heart Failure Clinical Trial
Official title:
Supporting Dyads Affected by Heart Failure - A Randomised Controlled Study Evaluating a Psychoeducational Intervention
The aim of this randomized controlled trial was to evaluate the effects of an integrated
dyad care program with education and psychosocial support to patients with chronic heart
failure and their partners during a post-discharge period after acute deterioration of heart
failure.
Methods: One hundred fifty five patient-caregiver dyads has been randomized to usual care or
a psycho-education intervention delivered in three modules through nurse-led face-to-face
counseling, computer-based education and other written teaching materials to assist dyads
develop problem-solving skills. Follow-up assessments has been completed after 3, 12 and 24
months to assess perceived control, perceived health, depressive symptoms, self-care,
knowledge, caregiver burden and health care utilization.
Heart failure is a serious condition with a poor prognosis. It is the leading cause of
hospitalization and readmissions for worsening heart failure remains high. Treatment aims to
reduce symptoms and morbidity and to improve quality of life and survival. Counseling and
education is an important part of treatment, but despite the fact that most patients receive
education, many are not able to adequately engage in self-care activities. Non-adherence to
self-care recommendations is high which may be a contributing factor for worsening heart
failure and to the high number of readmissions.
Having support of a partner is important for patients with heart failure. Supportive others
have the potential to improve self-care outcomes and increase adherence to treatment. At the
same time, it should be acknowledged that the disease can also affect the partners
negatively. However, emotional reactions of burden and stress decrease when partner's
experiences control over the heart disease.
Despite the fact that heart failure has a number of negative consequences for patients and
the partners, research addressing self-care barriers from a family perspective is rare, and
until now contemporary care has remained patient focused. Previous studies have indicated
the importance of partner support but have not found the appropriate methods for involving
and encourage partners. Therefore, studies focusing on the heart failure patient-partner
dyad are needed, but to date, most studies have only evaluated short term effects of
intervention programs, while long term effects might be of equally importance. The aim of
this randomized controlled study was to evaluate the effects of an integrated dyad care
program with education and psychosocial support to patients with chronic heart failure and
their partners during a post-discharge period after acute deterioration of heart failure.
Methods: One hundred fifty five patient-caregiver dyads has been randomized to usual care (n
= 71) or a psycho-education intervention (n = 84) delivered in three modules through
nurse-led face-to-face counseling, computer-based education and other written teaching
materials to assist dyads develop problem-solving skills. Follow-up assessments has been
completed after 3, 12 and 24 months to assess perceived control, perceived health,
depressive symptoms, self-care, knowledge, caregiver burden and health care utilization.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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