Randomized control trial of a self-management intervention for heart failure older adults in Northern Taiwan

Background. Heart failure patients often experience a high-level symptom burden, and the symptoms are greatly influenced by sodium and water intake. Moreover, Chinese older adults have specific dietary customs and rely on their families for food preparation. Aims. To determine the effectiveness of a self-management program for older adults with heart failure using randomized controlled trial Methods. Data were collected from August 2012 to July 2015, and 175 participants were randomly assigned to three groups, including patients alone and with caregiver-involved intervention (n = 60 and 55, respectively) who received an 8-week self-management program, and a control group (n = 60) receiving standard cardiology care only. Heart failure symptoms and self-efficacy for salt and fluid control were measured at baseline, 3 ^rd , 6 ^th , and 12 ^th months. The generalised estimating equation was used to analyse the data. Findings. Results showed that the heart failure self-management program improved patients’ symptoms significantly, but no differences were observed in self-efficacy for salt and fluid control. No significant differences were observed in intervention effects in patients with and without caregiver involvement. Discussion. Having a caregiver involvement or not made no difference in effects of the program. The Chinese culture provides an explanation because older adults tend to live with their family, even if the caregiver did not enroll in the program, patients still received help from their family. Conclusion. For older adult patients, home-based program allows nurses to evaluate and intervene on an individual basis, and providing booster sessions or individual follow-up are suggested to help patients adhere to long-term behaviour change.