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Effects of Tailored Supportive Education on Physical, Emotional Status and Quality of Life in Patients with Congestive Heart Failure

Eun-Sook Lee1, Eun-Suk Shin2, Seon-Young Hwang3, Myeong Jeong Chae4, Myoung-Ho Jeong5
Korean Journal of Adult Nursing 2013;25(1):62-73.
Published online: February 18, 2013

1College of Nursing, Chonnam National University, Gwangju

2Department of Infection Control, Chonnam National University Hospital, Gwangju

3Department of Nursing, Hanyang University, Seoul

4Department of Nursing, Kwangju Women's University, Gwangju

5Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea

Corresponding author: Shin, Eun-Suk Department of Infection Control, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 501-757, Korea. Tel: +82-62-220-5317, Fax: +82-62-220-5323, E-mail: ses00296@hanmail.net
• Received: November 16, 2012   • Accepted: February 20, 2013

© 2013 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    This study was conducted to examine the effects of tailored supportive education on physical, psychological status and quality of life in the patients with congestive heart failure (CHF) who had not participated previously in cardiac rehabilitation program.
  • Methods
    This study was used a non-equivalent control pre-post design, conducted on 64 CHF patients under medical treatment in a hospital. The experimental group (n=31) received the tailored supportive educational program (once 1~2 days before discharge and 6 times after discharge through outpatient visits or telephone contact: once every week for the first 4 weeks after discharge and once every 2 weeks for the remaining 4 weeks). The control group (n=33) received a traditional discharge education. Data were analyzed using descriptive statistics, x2-test, Fisher's exact test, t-test and repeated measure ANOVA using the SPSS/ WIN 18.0 program.
  • Results
    Participants in the experimental group showed the significantly increased scores of the quality of life (F=16.01, p <.001), and the significantly decreased scores of physical function (F=7.27, p =.009), depression (F=8.25, p =.006) and anxiety (F=4.11, p =.047), when compared to those of the control group.
  • Conclusion
    The findings indicated tailored supportive education was an effective intervention care in physical, emotional status and quality of life for CHF patients.
  • Key Words: Heart failure; Quality of life; Patient education
Figure 1.
Research design of this study.
kjan-25-62f1.jpg
Table 1.
Homogeneity Test on Demographic and Clinical Characteristics of Subjects (N=64)
Variables Categories Exp. (n=31) Cont. (n=33) x2 or t p
n (%) or M±SD n (%) or M±SD
Gender Male 13 (41.9) 18 (54.5) 1.02 .313
Female 18 (58.1) 15 (45.5)
Age (year)   65.4±14.5 63.1±12.2 0.68 .501
≥70 15 (48.3) 13 (39.4)
＜70 16 (51.7) 20 (60.6)
Marital status Married 25 (80.6) 31 (93.9) - .142†
Single 6 (19.4) 2 (6.1)
Education level ≤Middle school 22 (70.9) 22 (66.7) 0.14 .711
≥High school 9 (29.1) 11 (33.3)
Occupation Employed 17 (54.8) 16 (48.5) 0.26 .611
Unemployed 14 (45.2) 17 (51.5)
Household income (10,000 won) ＞100 8 (25.8) 5 (15.2) 1.12 .290
≤100 23 (74.2) 28 (84.8)
BMI (kg/m2)   23.4±3.5 24.1±3.6 0.01 .942
＞25 11 (35.5) 12 (36.4)
≤25 20 (64.5) 21 (63.6)
Comorbidity‡ DM (yes) 10 (32.3) 8 (24.2) 0.78 .437
Hypertension (yes) 16 (51.6) 13 (39.4)
NYHA class II 20 (64.5) 24 (72.7) 0.50 .479
III 11 (35.5) 9 (27.3)
LVEF (%) ＜40 16 (51.6) 13 (39.4) 0.96 .326
≥40 15 (48.4) 20 (60.6)
Pulmonary edema Yes 20 (64.5) 25 (75.8) 0.97 .325
No 11 (35.5) 8 (24.2)

DM=diabetes mellitus; NYHA=New York Heart Association; LVEF=left ventricular ejection fraction; Exp.=experimental group; Cont.=control group. BMI=body mass index.

†Fisher's exact test,

‡Multiple response.

Table 2.
Homogeneity Test on Dependent Variables (N=64)
Variables Categories Exp. (n=31) Cont. (n=33) t p
M±SD M±SD
Physical status Physical symptoms 16.55±3.15 15.55±3.73 1.16 .251
Physical function 26.34±17.18 31.85±18.61 -1.23 .224
Emotional status Depression 12.32±1.97 11.42±3.02 1.40 .167
Anxiety 6.39±3.39 5.76±3.49 0.73 .468
Health-related quality of life   38.74±10.16 38.21±12.90 0.18 .856

Exp.=experimental group; Cont.=control group.

Table 3.
Effect of Intervention on Physical, Emotional Status and Quality of Life of the Study Subjects (N=64)
Variables Categories Groups Pretest Posttest 1 (after 4 week) Posttest 2 (after 8 week) Source F† p
M±SD M±SD M±SD
Physical status Physical symptoms Exp. (n=31) 16.55±3.15 13.42±3.45 13.29±3.06 Group 0.15 .701
Cont. (n=33) 15.55±3.73 14.33±3.59 14.24±3.54 Time 3.84 .027
t (p) 1.16 (.251) -1.04 (.303) -1.15 (.255) Group×Time 4.78 .033
Physical function Exp. (n=31) 26.34±17.18 31.22±17.48 39.05±16.47 Group 0.01 .943
Cont. (n=33) 31.85±18.61 33.50±14.81 30.52±17.46 Time 3.96 .024
t (p) -1.23 (.224) -0.57 (.574) 2.01 (.049) Group×Time 7.27 .009
Emotional status l Depression Exp. (n=31) 12.32±1.97 11.87±1.96 10.61±1.82 Group 0.01 .939
Cont. (n=33) 11.42±3.02 11.73±2.49 11.76±2.14 Time 5.03 .010
t (p) 1.40 (.167) 0.26 (.799) -2.30 (.025) Group×Time 8.15 .006
Anxiety Exp. (n=31) 6.39±3.39 5.06±3.47 4.03±2.44 Group 0.80 .376
Cont. (n=33) 5.76±3.49 5.55±3.54 6.00±3.64 Time 3.98 .024
t (p) 0.73 (.468) -0.55 (.585) -2.55 (.013) Group×Time 6.52 .013
Quality of life Exp. (n=31) 38.74±10.16 35.74±10.29 34.90±8.89 Group 1.57 .215
Cont. (n=33) 38.21±12.90 38.52±12.09 42.73±13.37 Time 7.99 .001
t (p) 1.82 (.856) -0.99 (.328) -2.77 (.008) Group×Time 16.01 ＜.001

Exp.=experimental group; Cont.=control group.

†Repeated measure ANOVA.

  • Austin J., Williams R., Ross L., Moseley L., Hutchison S.. 2005;Randomised controlled trial of cardiac rehabilitation in elderly patients with heart failure. The European Journal of Heart Failure. 7:411-417.
  • Delaney C., Apostolidis B.. 2010;Pilot testing of a multicomponent home care intervention for older adults with heart failure: An academic clinical partnership. Journal of Cardiovascular Nursing. 25(5):27-40. http://dx.doi.org/10.1097/JCN.0b013e3181da2f79.
  • Faul F., Erdfelder E., Lang A. G., Buchner A.. 2007;G∗ Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 39:175-191.
  • Gary R. A., Dunbar S. B., Higgins M. K., Musselman D. L., Smith A. L.. 2010;Combined exercise and cognitive behavioral therapy improves outcomes in patients with heart failure. Journal of Psychosomatics Research. 69:119-131. http://dx.doi.org/10.1016/j.jpsychores.2010.01.013.
  • Heart Failure Society of America. 2006;Educational modules on heart failure Retrieved February 15, 2002, from HFSA Web site:.http://www.hfsa.org/heart_failure_education_modules.asp.
  • Jessup M., Abraham W. T., Casey D. E., Feldman A. M., Francis G. S., Ganiats T. G., et al. 2009;Focused update: ACCF/AHA guidelines for the diagnosis and management of heart failure in adults. Circulation. 119:1977-2016. http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064. Epub 2009 Mar 26.
  • Juenger J., Schellberg D., Kraemer S., Haunstetter A., Zugck C., Herzog W., et al. 2002;Health related quality of life in patients with congestive heart failure: Comparison with other chronic diseases and relation to functional variables. Heart. 87:235-241.
  • Kim C. J., Kim G Y., Noh Y. S., Song E. K., Kang S. M., Yoo M. S., et al. 2006;Relationship between psychosocial factors and symptom experience in patients with cardiovascular disease: Over a six-month follow-up period. The Korean Journal of Fundamentals of Nursing. 13(1):76-85.
  • Kim Y. S.. 2007;A path analysis model of health-related quality of life in patients with heart failure. Korean Journal of Adult Nursing. 19:547-555.
  • Koelling T. M., Johnson M. L., Cody R. J., Aaronson K. D.. 2005;Discharge education improves clinical outcomes in patients with chronic heart failure. Circulation. 111:179-185.
  • Kulcu D. G., Kurtais Y., Tur B. S., Gülec S., Seckin B.. 2007;The effect of cardiac rehabilitation on quality of life, anxiety and depression in patients with congestive heart failure: A randomized controlled trial, short-term results. Europa Me-dicophysica. 43:489-497.
  • Lee L. Y., Lee D. T., Woo J.. 2009;Tai chi and health-related quality of life in nursing home residents. Journal of Nursing Scholarship. 41(1):35-43.
  • Lee S. H., Ahn S. H.. 2005;Self care compliance, family support, and depression in patients with congestive heart failure. The Korean Journal of Fundamentals of Nursing. 12:186-194.
  • Lenz E. R., Pugh L. C., Milligan R. A., Gift A., Suppe F.. 1997;The middle-range theory of unpleasant symptoms: An update. Advanced Nursing Science. 19(3):14-27.
  • Lewis S. M., Heitkemper M. M., Dirksen S. R., O'brien P. G., Giddens J. F., Bucher L.. 2004. Medical-surgical nursing: Assessment and management of clinical problems. 6th ed.. St. Louis, Missouri: Mosby.
  • Moser D. K., Watkins J. F.. 2008;Conceptualizing self-care in heart failure: A life course model of patient characteristics. Journal of Cardiovascular Nursing. 23:205-218. http://dx.doi.org/10.1097/01.JCN.0000305097.09710.a5.
  • O'Connor C. M., Whellan D. J., Lee K. L., Keteyian S. J., Cooper L. S., Ellis S. J., et al. 2009;Efficacy and safety of exercise training in patients with chronic heart failure. Journal of American Medical Association. 301:1439-1450. http://dx.doi.org/10.1001/jama.2009.454.
  • Oh S. M., Min K. J., Park D. B.. 1999;A study on the standardization of the hospital anxiety and depressed scale for Koreans. Journal of the Korean Neuropsychiatric Association. 38:289-296.
  • Palmer N. D., Appleton B., Rodregues E. A.. 2003;Specialist nurse-led intervention in outpatients with congestive heart failure: Impact on clinical and economic outcomes. Disease Management & Health Outcomes. 11:693-698.
  • Park K. S.. 2007;A study on the difference in perception on educational needs in patients with heart failure and nurses Unpublished master's thesis, Hanyang University, Seoul..
  • Rector T. S., Kubo S. H., Cohn J. N.. 1987;Patient's self-assessment of their congestive heart failure. Part 2: Content, reliability and validity of a new measure, the minnesota living with heart failure questionnaire. Heart Failure. 3:198-207.
  • Riegel B., Carlson B., Glaser D.. 2000;Development and testing of a clinical tool measuring self-management of heart failure. Heart & Lung. 29(1):4-15.
  • Song E. K.. 2005;Effect of a telephone monitoring on self- management & symptom experiences in patients with heart failure. Korean Journal of Adult Nursing. 17(1):56-67.
  • Song E. K., Kim C. J., Yoo I. Y., Kim G. Y., Kim J. H., Ha J. W.. 2006;Factors influencing functional status in patients with heart failure. Journal of Korean Academy Nursing. 36:853-862.
  • Statistics Korea. 2010;Cause of death statistics table Retrieved July 15, 2012, from Web site:.http://kostat.go.kr/portal/korea/kor_nw/2/6/2/index.board?bmode=read&bSeq=&aSeq=250282&pageNo=1&rowNum=10&navCount=10&currPg=&sTarget=title&sTxt=.
  • Sung J. D., On Y. K., Kim H. S., Chae I. H., Sohn D. W., Oh B. H., et al. 2000;Development of Korean activity scale/index (KASI). Korean Circulation Journal. 30:1004-1009.
  • Tahylor-Piliae R. E., Haskell W. L., Waters C. M., Froelicher E. S.. 2006;Change in perceived psychosocial status following a 12-week tai chi exercise programme. Journal of Advanced Nursing. 54:313-329.
  • Yeh G. Y., Wayne P. M., Phillips R. S.. 2008;Tai chi exercise in patients with chronic heart failure. Medical Sport Science, Basel, Karger. 52:195-208. http://dx.doi.org/10.1159/000134300.
  • Yu D. S., Lee D. T., Woo J.. 2010;Improving health-related quality of life patients with chronic heart failure: Effects of relaxation therapy. Journal of Advanced Nursing. 66:392-403. http://dx.doi.org/10.1111/j.1365-2648.2009.05198.x.
  • Zigmond A. S., Snaith R. P.. 1983;The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 67:361-370.

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    Citations

    Citations to this article as recorded by  
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    Effects of Tailored Supportive Education on Physical, Emotional Status and Quality of Life in Patients with Congestive Heart Failure
    Korean J Adult Nurs. 2013;25(1):62-73.   Published online February 28, 2013
    DOI: https://doi.org/10.7475/kjan.2013.25.1.62
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    Effects of Tailored Supportive Education on Physical, Emotional Status and Quality of Life in Patients with Congestive Heart Failure
    Korean J Adult Nurs. 2013;25(1):62-73.   Published online February 28, 2013
    DOI: https://doi.org/10.7475/kjan.2013.25.1.62
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    Effects of Tailored Supportive Education on Physical, Emotional Status and Quality of Life in Patients with Congestive Heart Failure
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    Figure 1. Research design of this study.

    Figure 1.

    Effects of Tailored Supportive Education on Physical, Emotional Status and Quality of Life in Patients with Congestive Heart Failure

    Homogeneity Test on Demographic and Clinical Characteristics of Subjects (N=64)

    Variables Categories Exp. (n=31) Cont. (n=33) x2 or t p
    n (%) or M±SD n (%) or M±SD
    Gender Male 13 (41.9) 18 (54.5) 1.02 .313
    Female 18 (58.1) 15 (45.5)
    Age (year)   65.4±14.5 63.1±12.2 0.68 .501
    ≥70 15 (48.3) 13 (39.4)
    ＜70 16 (51.7) 20 (60.6)
    Marital status Married 25 (80.6) 31 (93.9) - .142†
    Single 6 (19.4) 2 (6.1)
    Education level ≤Middle school 22 (70.9) 22 (66.7) 0.14 .711
    ≥High school 9 (29.1) 11 (33.3)
    Occupation Employed 17 (54.8) 16 (48.5) 0.26 .611
    Unemployed 14 (45.2) 17 (51.5)
    Household income (10,000 won) ＞100 8 (25.8) 5 (15.2) 1.12 .290
    ≤100 23 (74.2) 28 (84.8)
    BMI (kg/m2)   23.4±3.5 24.1±3.6 0.01 .942
    ＞25 11 (35.5) 12 (36.4)
    ≤25 20 (64.5) 21 (63.6)
    Comorbidity‡ DM (yes) 10 (32.3) 8 (24.2) 0.78 .437
    Hypertension (yes) 16 (51.6) 13 (39.4)
    NYHA class II 20 (64.5) 24 (72.7) 0.50 .479
    III 11 (35.5) 9 (27.3)
    LVEF (%) ＜40 16 (51.6) 13 (39.4) 0.96 .326
    ≥40 15 (48.4) 20 (60.6)
    Pulmonary edema Yes 20 (64.5) 25 (75.8) 0.97 .325
    No 11 (35.5) 8 (24.2)

    DM=diabetes mellitus; NYHA=New York Heart Association; LVEF=left ventricular ejection fraction; Exp.=experimental group; Cont.=control group. BMI=body mass index.

    †Fisher's exact test,

    ‡Multiple response.

    Homogeneity Test on Dependent Variables (N=64)

    Variables Categories Exp. (n=31) Cont. (n=33) t p
    M±SD M±SD
    Physical status Physical symptoms 16.55±3.15 15.55±3.73 1.16 .251
    Physical function 26.34±17.18 31.85±18.61 -1.23 .224
    Emotional status Depression 12.32±1.97 11.42±3.02 1.40 .167
    Anxiety 6.39±3.39 5.76±3.49 0.73 .468
    Health-related quality of life   38.74±10.16 38.21±12.90 0.18 .856

    Exp.=experimental group; Cont.=control group.

    Effect of Intervention on Physical, Emotional Status and Quality of Life of the Study Subjects (N=64)

    Variables Categories Groups Pretest Posttest 1 (after 4 week) Posttest 2 (after 8 week) Source F† p
    M±SD M±SD M±SD
    Physical status Physical symptoms Exp. (n=31) 16.55±3.15 13.42±3.45 13.29±3.06 Group 0.15 .701
    Cont. (n=33) 15.55±3.73 14.33±3.59 14.24±3.54 Time 3.84 .027
    t (p) 1.16 (.251) -1.04 (.303) -1.15 (.255) Group×Time 4.78 .033
    Physical function Exp. (n=31) 26.34±17.18 31.22±17.48 39.05±16.47 Group 0.01 .943
    Cont. (n=33) 31.85±18.61 33.50±14.81 30.52±17.46 Time 3.96 .024
    t (p) -1.23 (.224) -0.57 (.574) 2.01 (.049) Group×Time 7.27 .009
    Emotional status l Depression Exp. (n=31) 12.32±1.97 11.87±1.96 10.61±1.82 Group 0.01 .939
    Cont. (n=33) 11.42±3.02 11.73±2.49 11.76±2.14 Time 5.03 .010
    t (p) 1.40 (.167) 0.26 (.799) -2.30 (.025) Group×Time 8.15 .006
    Anxiety Exp. (n=31) 6.39±3.39 5.06±3.47 4.03±2.44 Group 0.80 .376
    Cont. (n=33) 5.76±3.49 5.55±3.54 6.00±3.64 Time 3.98 .024
    t (p) 0.73 (.468) -0.55 (.585) -2.55 (.013) Group×Time 6.52 .013
    Quality of life Exp. (n=31) 38.74±10.16 35.74±10.29 34.90±8.89 Group 1.57 .215
    Cont. (n=33) 38.21±12.90 38.52±12.09 42.73±13.37 Time 7.99 .001
    t (p) 1.82 (.856) -0.99 (.328) -2.77 (.008) Group×Time 16.01 ＜.001

    Exp.=experimental group; Cont.=control group.

    †Repeated measure ANOVA.
    Table 1. Homogeneity Test on Demographic and Clinical Characteristics of Subjects (N=64)

    DM=diabetes mellitus; NYHA=New York Heart Association; LVEF=left ventricular ejection fraction; Exp.=experimental group; Cont.=control group. BMI=body mass index.

    Fisher's exact test,

    Multiple response.

    Table 2. Homogeneity Test on Dependent Variables (N=64)

    Exp.=experimental group; Cont.=control group.

    Table 3. Effect of Intervention on Physical, Emotional Status and Quality of Life of the Study Subjects (N=64)

    Exp.=experimental group; Cont.=control group.

    Repeated measure ANOVA.

    Table 1.

    Table 2.

    Table 3.

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