Developing and evaluating a Kano model-based discharge nursing intervention for older adults with chronic heart failure: a pilot study on effects on readiness, quality of life, and self-management

Objective To explore the post-discharge nursing service needs of elderly patients with chronic heart failure (CHF) and evaluate the effect of targeted interventions on improving quality of life and reducing self-management. Methods A questionnaire based on the Kano model was designed to survey 300 elderly CHF patients. Interventions included personalized health education, regular follow-up, and psychological support. The intervention effects were evaluated by comparing the scores of Readiness for Hospital Discharge Scale (RHDS), Minnesota Living with Heart Failure Questionnaire (MLHFQ), Heart Failure Self-Management Scale of patients (SCHFI) and readmission rates between two groups. Results Based on the Kano model survey, patient needs were categorized into must-be, one-dimensional, and attractive attributes, guiding the design of tailored interventions. Compared to the control group, the Kano group with notable gains across all RHDS dimensions—particularly in knowledge and coping ability. MLHFQ improved in the Kano group, significantly exceeding in controls ( P < 0.05), with benefits observed across physical, emotional, and social domains. SCHFI scores also improved more substantially in the Kano group, especially in maintenance, management, and confidence. At 3 months post-discharge, the readmission rate was 5% in the Kano group versus 15% in the control group ( P < 0.01). Conclusion Nursing service based on the Kano model and targeted interventions can effectively improve the quality of life and self-management ability of elderly CHF patients. However, larger sample sizes and long-term studies are needed to validate the generalizability of the findings.