September 25, 2015Open Access

Long Term Follow-Up after a Randomized Integrated Educational and Psychosocial Intervention in Patient-Partner Dyads Affected by Heart Failure

Structured PICO

Does a nurse-led psychoeducational intervention improve health, depressive symptoms, perceived control, or event-free survival in heart failure patient-partner dyads?

Population

155 patient-partner dyads (patients with verified heart failure, NYHA class II-IV, recently discharged 2-3 weeks following acute exacerbation, cohabiting with a partner). Excluded: diagnosed dementia, severe psychiatric illnesses, drug abuse, language barriers, or planned cardiac surgery.

Intervention

Nurse-led psychoeducational support program consisting of three face-to-face sessions (at 2, 6, and 12 weeks post-discharge) addressing cognitive, supportive, and behavioral components, added to care as usual.

Comparator

Care as usual (optimized treatment according to international guidelines, and standard verbal and written patient education).

Outcome

24-month effects on health (SF-36), depressive symptoms (BDI-II), perceived control (CAS), and time to first event (readmission or death).patient reported

A 12-week nurse-led psychoeducational intervention for heart failure patients and their partners did not significantly improve long-term clinical outcomes, health status, or depressive symptoms at 24 months.

Abstract

BACKGROUND: To date, contemporary heart failure care remains patient-focused, but awareness of the partners' and families' situation is increasing. Randomized studies have mainly evaluated the short-term effects of dyadic interventions. Therefore, the aim of this study was to determine the 24-month effects of an intervention with psych-educational support in dyads of heart failure patients and their partners. METHODS: This study used a randomized study design and 155 patient-partner dyads were enrolled. The intervention included a nurse-led program of three sessions addressing psychoeducational support. RESULTS: The intervention did not have any effect on health, depressive symptoms or perceived control among the patient-partner dyads after 24 months. Furthermore, time to first event did not differ significantly between the intervention group and the control patients. CONCLUSION: This study may be regarded as a first step in trying to understand dyads' need for supportive care. Individualized and more targeted interventions seem necessary to achieve a higher impact on dyad outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT02398799.

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