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A pilot test of an integrated self-care intervention for persons with heart failure and concomitant diabetes

Publication ,  Journal Article
Dunbar, SB; Butts, B; Reilly, CM; Gary, RA; Higgins, MK; Ferranti, EP; Culler, SD; Butler, J
Published in: Nursing Outlook
2013

Studies show 30% to 47% of people with heart failure (HF) have concomitant diabetes mellitus (DM). Self-care for persons with both of these chronic conditions is conflicting, complex, and often inadequate. This pilot study tested an integrated self-care program for its effects on HF and DM knowledge, self-care efficacy, self-care behaviors, and quality of life (QOL). Hospitalized HF-DM participants (N = 71) were randomized to usual care or intervention using a 1:2 allocation and followed at 30 and 90 days after intervention. Intervention was an integrated education and counseling program focused on HF-DM self-care. Variables included demographic and clinical data, knowledge about HF and DM, HF- and DM-specific self-efficacy, standard HF and DM QOL scales, and HF and DM self-care behaviors. Analysis included descriptive statistics, multilevel longitudinal models for group and time effects, post hoc testing, and effect size calculations. Sidak adjustments were used to control for type 1 error inflation. The integrated HF-DM self-care intervention conferred effects on improved HF knowledge (30 days, p = .05), HF self-care maintenance (30 and 90 days, p < .001), HF self-care management (90 days, p = .05), DM self-efficacy (30 days, p = .03; 90 days, p = .004), general diet (30 days, p = .05), HF physical QOL (p = .04), and emotional QOL scores (p = .05) at 90 days within the intervention group. The participants in the usual care group also reported increased total and physical QOL. Greater percentages of participants in the intervention group improved self reported exercise between 0 and 30 days (p = .005 and moderate effect size ES = .47) and foot care between 0 and 90 days (p = .03, small ES = .36). No group differences or improvements in DM-specific QOL were observed. An integrated HF-DM self-care intervention was effective in improving essential components of self-care and had sustained (90 day) effects on selected self-care behaviors. Future studies testing HF-DM integrated self-care interventions in larger samples with longer follow-up and on other outcomes such as hospitalization and clinical markers are warranted. © 2013 Elsevier Inc. All rights reserved.

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Published In

Nursing Outlook

DOI

ISSN

0029-6554

Publication Date

2013

Related Subject Headings

  • Nursing
  • 1110 Nursing
 

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Dunbar, S. B., Butts, B., Reilly, C. M., Gary, R. A., Higgins, M. K., Ferranti, E. P., … Butler, J. (2013). A pilot test of an integrated self-care intervention for persons with heart failure and concomitant diabetes. Nursing Outlook. https://doi.org/10.1016/j.outlook.2013.09.003
Dunbar, S. B., B. Butts, C. M. Reilly, R. A. Gary, M. K. Higgins, E. P. Ferranti, S. D. Culler, and J. Butler. “A pilot test of an integrated self-care intervention for persons with heart failure and concomitant diabetes.” Nursing Outlook, 2013. https://doi.org/10.1016/j.outlook.2013.09.003.
Dunbar SB, Butts B, Reilly CM, Gary RA, Higgins MK, Ferranti EP, et al. A pilot test of an integrated self-care intervention for persons with heart failure and concomitant diabetes. Nursing Outlook. 2013;
Dunbar, S. B., et al. “A pilot test of an integrated self-care intervention for persons with heart failure and concomitant diabetes.” Nursing Outlook, 2013. Scival, doi:10.1016/j.outlook.2013.09.003.
Dunbar SB, Butts B, Reilly CM, Gary RA, Higgins MK, Ferranti EP, Culler SD, Butler J. A pilot test of an integrated self-care intervention for persons with heart failure and concomitant diabetes. Nursing Outlook. 2013;
Journal cover image

Published In

Nursing Outlook

DOI

ISSN

0029-6554

Publication Date

2013

Related Subject Headings

  • Nursing
  • 1110 Nursing