Effects of a Periodic Assessment of Heart Failure and Depressive Symptoms on Self-Care in Outpatients with Heart Failure: A Randomized Controlled Trial

JinShil Kim; Jisun  Yang; KyungAh  Cho; Sang Yi  Baek; Seongkum Heo

doi:10.18502/ijph.v54i8.19581

JinShil Kim Gachon University, College of Nursing, Incheon, South Korea
Jisun Yang Gachon University Gil Hospital, Incheon, South Korea
KyungAh Cho Gachon University, College of Nursing, Incheon, South Korea
Sang Yi Baek Gachon University, College of Nursing, Incheon, South Korea
Seongkum Heo Mercer University, Georgia Baptist College of Nursing, 3001 Mercer University Drive, Atlanta, GA 30341, USA

DOI: https://doi.org/10.18502/ijph.v54i8.19581

Keywords: Assessment; Heart failure; Depression; Symptoms; Self-care

Abstract

Background: Periodic symptom assessment in outpatient settings may enhance self-care in heart failure (HF) patients, though its effects are not fully studied. This study examined the impact of periodic HF and depressive symptom assessments on self-care (maintenance, symptom perception, and management) over nine months.

Methods: In this randomized controlled trial, symptom assessments were conducted in the intervention group at baseline and at three, six, and nine months in South Korea between Sep 2022 and Nov 2023. Data on self-care were collected at baseline and at nine-month follow-up. A series of two-way repeated measures analysis of variance were used to address the purpose.

Results: The only variable that showed a significant difference between the intervention group (n=17, age=64.8 yr) and the control group (n=21, age=64.6 yr) from baseline to nine-month follow-up was self-care maintenance. The main effect of time on self-care maintenance was statistically significant, improving from baseline to follow-up regardless of group (F[1,36])=26.53, P<0.001). A significant group-by-time interaction (F[1,36] = 26.53, P=0.015) indicated the changes in self-care maintenance varied over time by group membership.

Conclusion: A periodic assessment of HF symptoms and depressive symptoms increased self-care maintenance, but did not affect other self-care behaviors, in outpatients with HF. Clinicians may consider regular outpatient symptom assessment as a tool for educational support to enhance self-care maintenance in patients with HF.