Culturally Adapted Digital Education to Improve Self-Care Among Patients With Heart Failure: A Quasi-Experimental Study

Background: Heart failure self-care remains suboptimal, while conventional education may be limited by time constraints and insufficient attention to patients’ cultural contexts. Evidence remains limited on digital education specifically adapted to local cultural values to improve self-care among patients with heart failure. This study examined changes in self-care among patients with heart failure who received local culture-based digital educational media compared with those who received standard hospital education. Methods: This quasi-experimental study used a non-equivalent pretest–posttest control group design and followed the TREND reporting guideline. A total of 140 patients with heart failure were selected using purposive sampling and allocated without randomization to intervention and control groups, each comprising 70 participants. The intervention group received local culture-based digital educational media in a single individual session, with video access via WhatsApp for independent repeat viewing as needed until posttest. In contrast, the control group received standard hospital education. Self-care was measured using the Self-Care of Heart Failure Index version 7.2 before education and 14 days after the initial education session. Within-group changes were analyzed using the Wilcoxon signed-rank test, and between-group differences in score changes were analyzed using the Mann–Whitney U test. Results: The median self-care score increased from 68.0 (Q1–Q3: 64.0–80.5) to 85.0 (78.0–99.8) in the intervention group, with a median change of 14.0 (9.0–20.5). In the control group, the median score changed from 69.5 (67.0–77.8) to 70.5 (67.3–77.8), with a median change of 0.0 (0.0–1.0). The between-group difference in change scores was statistically significant (U = 23.0; p < 0.001), with an estimated difference of 13.0 points (95% CI: 12.0–15.0) and an absolute rank-biserial correlation of 0.991. Conclusion: Local culture-based digital educational media were associated with greater improvement in self-care than standard hospital education among patients with heart failure. The intervention may complement nurse-led education by providing culturally relevant, understandable, and reviewable information to support continued self-care.