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Nurse-led heart failure clinics improve survival and self-care behaviour in patients with heart failure: Results from a prospective, randomised trial
Linköpings universitet, Institutionen för medicin och vård, Kardiologi. Linköpings universitet, Hälsouniversitetet.ORCID-id: 0000-0002-4259-3671
Department of Medicine, County Hospital Ryhov, Jönköping, Sweden and chool of Social and Health Sciences, Halmstad University, Halmstad, Sweden and Unit of Research and Development in Primary Health Care, Jönköping, Sweden .
Linköpings universitet, Institutionen för medicin och vård. Linköpings universitet, Hälsouniversitetet.
Linköpings universitet, Institutionen för hälsa och samhälle, Centrum för utvärdering av medicinsk teknologi. Linköpings universitet, Hälsouniversitetet.
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2003 (Engelska)Ingår i: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 24, nr 11, s. 1014-1023Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Aim The aim of this trial was to prospectively evaluate the effect of follow-up at a nurse-led heart failure clinic on mortality, morbidity and self-care behaviour for patients hospitalised due to heart failure for 12 months after discharge.

Methods A total of 106 patients were randomly assigned to either follow-up at a nurse-led heart failure clinic or to usual care. The nurse-led heart failure clinic was staffed by specially educated and experienced cardiac nurses, delegated the responsibility for making protocol-led changes in medications. The first follow-up visit was 2–3 weeks after discharge. During the visit the nurse evaluated the heart failure status and the treatment, gave education about heart failure and social support to the patient and his family.

Results There were fewer patients with events (death or admission) after 12 months in the intervention group compared to the control group (29 vs 40, p=0.03) and fewer deaths after 12 months (7 vs 20, p=0.005). The intervention group had fewer admissions (33 vs 56, p=0.047) and days in hospital (350 vs 592, p=0.045) during the first 3 months. After 12 months the intervention was associated with a 55% decrease in admissions/patient/month (0.18 vs 0.40, p=0.06) and fewer days in hospital/patient/month (1.4 vs 3.9, p=0.02). The intervention group had significantly higher self-care scores at 3 and 12 months compared to the control group (p=0.02 and p=0.01).

Conclusions Follow up after hospitalisation at a nurse-led heart failure clinic can improve survival and self-care behaviour in patients with heart failure as well as reduce the number of events, readmissions and days in hospital.

Ort, förlag, år, upplaga, sidor
2003. Vol. 24, nr 11, s. 1014-1023
Nyckelord [en]
Heart failure, Heart failure clinics, Mortality, Nursing, Patient education, Self-care
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:liu:diva-46609DOI: 10.1016/S0195-668X(03)00112-XOAI: oai:DiVA.org:liu-46609DiVA, id: diva2:267505
Anmärkning

On the day of the defence day the status of this article was a manuscript

Tillgänglig från: 2009-10-11 Skapad: 2009-10-11 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
Ingår i avhandling
1. Caring for patients with chronic heart failure
Öppna denna publikation i ny flik eller fönster >>Caring for patients with chronic heart failure
2001 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

The overall aim of this thesis was to describe and evaluate patient education and nurse-led follow up for patients with heart failure. Descriptive designs were used to map out the nurse-led heart failure care in Sweden (I) and to identify factors influencing compliance with prescribed treatment in patients with chronic heart failure.(II) An interactive computer-based multimedia program for the education of patients with heart failure was developed and tested (III) and the effects on knowledge, compliance and quality of life evaluated in a randomised study. (IV) The effects of nurse-led heart failure clinics on mortality, morbidity, health-related quality of life and self-care behaviour in patients hospitalised due to heart failure were also evaluated in a randomised study.(V) Heart failure nurses and nurse-led heart failure clinics were introduced in Sweden in 1990. After 8 years the model has  spread to two thirds of the Swedish hospitals. In total 148 heart failure nurses were involved in education and follow up of patients with heart failure. (I) The compliance with therapeutic regimens was influenced by inward factors; the personality of the patient, the disease and the treatment and outward factors; social activities and relationships to family, friends and health care professionals.(II) The patients with heart failure were satisfied with computer-based education and positive in their attitude towards the computer. There was no need for computer experience in order to run an interactive computer-based program and high age was not a problem for using the program independently.(III) Computer-based education gave increased and more lasting knowledge about heart failure compared to traditional teaching, but compliance was not improved by single-session education. Quality of life was improved after 6 months by both traditional and computer-based education, but only for the men. (IV) Follow up after hospitalisation at a nurse-led heart failure clinic improved survival and selfcare behaviour in patients with heart failure as well as reduced the number of events, readmissions and days in hospital. (V)

Ort, förlag, år, upplaga, sidor
Linköping: Linköpings universitet, 2001. s. 72
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 708
Nyckelord
caring, compliance, computer-based education, follow up, heart failure, intervention, nurse-led heart failure clinics, morbidity, mortality, patient education, quality of life, self-care
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:liu:diva-27544 (URN)12204 (Lokalt ID)91-7373-144-7 (ISBN)12204 (Arkivnummer)12204 (OAI)
Disputation
2001-12-10, Berzeliussalen, Universitetssjukhuset, Linköping, 09:00 (Svenska)
Opponent
Tillgänglig från: 2009-10-08 Skapad: 2009-10-08 Senast uppdaterad: 2013-09-03Bibliografiskt granskad

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Strömberg, AnnaLevin, Lars-ÅkeDahlström, Ulf

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KardiologiHälsouniversitetetInstitutionen för medicin och vårdCentrum för utvärdering av medicinsk teknologiKardiologi
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