A motivational intervention involving home visits by an advanced practice nurse improved heart failure self-care in 71.4% of participants over a three-month period.
Does a motivational counseling intervention improve self-care in patients hospitalized with heart failure?
A motivational counseling intervention delivered by an advanced practice nurse over three months improved self-care in 71.4% of heart failure patients.
BACKGROUND: Self-care is an integral component of successful heart failure (HF) management. Engaging patients in self-care can be challenging. METHODS: Fifteen patients with HF enrolled during hospitalization received a motivational intervention designed to improve HF self-care. A mixed method, pretest posttest design was used to evaluate the proportion of patients in whom the intervention was beneficial and the mechanism of effectiveness. Participants received, on average, 3.0 +/- 1.5 home visits (median 3, mode 3, range 1-6) over a three-month period from an advanced practice nurse trained in motivational interviewing and family counseling. Quantitative and qualitative data were used to judge individual patients in whom the intervention produced a clinically significant improvement in HF self-care. Audiotaped intervention sessions were analyzed using qualitative methods to assess the mechanism of intervention effectiveness. RESULTS: Congruence between quantitative and qualitative judgments of improved self-care revealed that 71.4% of participants improved in self-care after receiving the intervention. Analysis of transcribed intervention sessions revealed themes of 1) communication (reflective listening, empathy); 2) making it fit (acknowledging cultural beliefs, overcoming barriers and constraints, negotiating an action plan); and, 3) bridging the transition from hospital to home (providing information, building skills, activating support resources). CONCLUSION: An intervention that incorporates the core elements of motivational interviewing may be effective in improving HF self-care, but further research is needed.
Riegel et al. (Mon,) conducted a other in Heart failure (n=15). Motivational intervention (motivational interviewing and family counseling) was evaluated on Proportion of patients with clinically significant improvement in HF self-care. A motivational intervention involving home visits by an advanced practice nurse improved heart failure self-care in 71.4% of participants over a three-month period.