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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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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Research

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

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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.

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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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