Boosting Heart Failure Self-Care with Nurse-Led Programs

Importance of Self-Care in Heart Failure Management

Heart failure (HF) is a significant global health challenge, affecting millions of individuals and leading to increased morbidity, mortality, and healthcare costs. Effective self-care practices are critical in managing HF, as they can significantly influence patient outcomes and quality of life. Self-care in HF encompasses daily activities that individuals engage in to manage their health, such as monitoring weight, adhering to medication regimens, and recognizing early symptoms of exacerbation.

Research has consistently shown that patients who engage in effective self-care behaviors experience fewer hospitalizations and improved overall health status (Groenewegen et al., 2020). However, studies indicate that many patients with HF struggle with self-care, often due to a lack of knowledge, support, and self-efficacy (Huang et al., 2023). Therefore, developing interventions that empower patients to take charge of their self-care is essential for enhancing their health outcomes.

The Role of the Common-Sense Model in Self-Regulation

The Common-Sense Model (CSM) of Self-Regulation provides a theoretical framework for understanding how individuals perceive their health conditions and the coping strategies they adopt. The CSM posits that illness perceptions influence self-management behaviors, thereby impacting health outcomes (Leventhal et al., 2016).

In the context of HF, patients’ beliefs about their condition, such as its severity, duration, and treatment efficacy, can shape their motivation to engage in self-care. For instance, patients who perceive HF as a manageable condition are more likely to adhere to self-care practices compared to those who view it as unmanageable. Additionally, self-efficacy, or the belief in one’s ability to perform self-care activities, plays a crucial role in the CSM. Patients with higher self-efficacy are more likely to engage in positive health behaviors and effectively manage their condition (Klompstra et al., 2018).

By addressing both illness perceptions and self-efficacy, nurse-led interventions can enhance patients’ ability to manage their HF effectively. This approach not only improves self-care behaviors but also fosters a greater sense of control over their health.

Designing an Effective Nurse-Led Self-Care Intervention

Developing a nurse-led self-care intervention tailored to the needs of individuals with HF involves several critical steps. The intervention should be based on the principles of the CSM and incorporate evidence-based strategies to promote self-care behaviors. Key components of an effective intervention may include:

1. Education: Providing comprehensive information about HF, including its causes, symptoms, and management strategies. Educational sessions should address common misconceptions and empower patients with the knowledge needed to make informed decisions about their care.

2. Skill Development: Teaching patients essential self-care skills, such as monitoring daily weight, managing fluid intake, and recognizing early signs of exacerbation. Practical demonstrations can facilitate learning and enhance confidence.

3. Goal-Setting: Encouraging patients to set realistic, achievable self-care goals. This process can involve collaborative discussions between nurses and patients to identify specific behaviors to target.

4. Support and Follow-Up: Implementing a structured follow-up plan to provide ongoing support and reinforcement. Regular check-ins, whether through phone calls or in-person visits, can help patients stay motivated and address any challenges they encounter.

5. Utilizing Technology: Integrating technology, such as mobile health applications, can enhance communication and support self-monitoring. These tools can provide reminders for medication adherence and prompt patients to log their daily self-care activities.

The proposed nurse-led self-care intervention aims to improve patients’ illness perceptions, enhance self-efficacy, and ultimately boost self-care behaviors among individuals with HF.

Pilot Study Results: Feasibility and Acceptability

A pilot study was conducted to evaluate the feasibility and acceptability of the nurse-led CSM of Self-Regulation-based self-care intervention. The pilot involved 26 participants diagnosed with HF who were randomly assigned to either the intervention group or a control group receiving usual care.

Table 1: Pilot Study Demographics and Outcomes

The eligibility rate was found to be 79.4%, with a recruitment rate of 96.3%. The intervention was considered acceptable, as 83.3% of the participants rated the content positively. Most participants recognized the benefits of the intervention, reporting improvements in illness perceptions, self-care self-efficacy, and self-care behaviors.

Evaluating the Impact on Patient Health Outcomes

The outcomes of the pilot study demonstrated significant improvements in key health metrics among participants in the intervention group compared to the control group. The intervention group exhibited:

• Improved Illness Perceptions: The intervention led to a substantial reduction in negative illness perceptions, enhancing participants’ understanding and management of their condition (β = -11.837, p < 0.001).

• Increased Self-Care Self-Efficacy: Participants reported higher levels of confidence in their ability to manage their self-care (β = 9.838, p < 0.001).

• Enhanced Self-Care Behaviors: There were significant improvements in self-care maintenance and management, indicating that the intervention effectively encouraged positive health behaviors (β = 10.969, p = 0.027).

Table 2: Changes in Health Outcomes

Conclusion

The findings from the pilot study highlight the feasibility and potential benefits of a nurse-led self-care intervention based on the Common-Sense Model of Self-Regulation for individuals with heart failure. By addressing illness perceptions and enhancing self-efficacy, the intervention can empower patients to engage in effective self-care, ultimately improving their health outcomes. Given the promising nature of these results, a full-scale randomized controlled trial (RCT) is warranted to further assess the intervention’s effectiveness.

FAQs

What is heart failure self-care?
Heart failure self-care refers to the daily activities and behaviors that patients with heart failure engage in to manage their condition, such as monitoring symptoms, adhering to medication, and managing lifestyle factors.

How can nurse-led interventions improve self-care in heart failure patients?
Nurse-led interventions can provide education, develop self-care skills, offer support, and help patients set and achieve self-care goals, thereby enhancing their ability to manage heart failure effectively.

What is the Common-Sense Model of Self-Regulation?
The Common-Sense Model of Self-Regulation is a theoretical framework that explains how individuals perceive their health conditions and make decisions about self-care, emphasizing the roles of illness perceptions and self-efficacy.

What were the results of the pilot study?
The pilot study showed significant improvements in illness perceptions, self-care self-efficacy, and self-care behaviors among participants in the intervention group compared to the control group.

What are the next steps after this pilot study?
The next steps include conducting a full-scale randomized controlled trial to rigorously evaluate the effectiveness of the nurse-led self-care intervention for heart failure patients.

References

1. Groenewegen, A., Rutten, F. H., Mosterd, A., & Hoes, A. W. (2020). Epidemiology of heart failure. Eur J Heart Fail, 22(8), 1342–1356

2. Huang, Z., Liu, T., & Chair, S. Y. (2023). Development and pilot testing of a nurse-led common-sense model of self-regulation-based heart failure self-care program. BMC Nurs, 22(1), 9. https://doi.org/10.1186/s12912-025-02722-9

3. Leventhal, H., Phillips, L. A., & Burns, E. (2016). The common-sense model of self-regulation (CSM): a dynamic framework for understanding illness self-management. J Behav Med, 39(6), 935–946

4. Klompstra, L., Jaarsma, T., & Strömberg, A. (2018). Self-efficacy mediates the relationship between motivation and physical activity in patients with heart failure. J Cardiovasc Nurs, 33(3), 211–216

5. Hertzog, M. A. (2008). Considerations in determining sample size for pilot studies. Res Nurs Health, 31(2), 180–191

6. Riegel, B., Dickson, V. V., & Faulkner, K. M. (2016). The Situation-Specific Theory of Heart failure Self-Care: revised and updated. J Cardiovasc Nurs, 31(3), 226–235