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Type: Journal article
Title: The effectiveness of patient-centered self-care education for adults with heart failure on knowledge, self-care behaviors, quality of life, and readmissions: a systematic review
Author: Casimir, Y.
Williams, M.
Liang, M.
Pitakmongkolkul, S.
Slyer, J.
Citation: The JBI Database of Systematic Reviews and Implementation Reports, 2014; 12(2):188-262
Publisher: The Joanna Briggs Institute, The University of Adelaide
Issue Date: 2014
ISSN: 2202-4433
Statement of
Yves E. Casimir, Marvelin M. Williams, Mei Y. Liang, Supawadee Pitakmongkolkul, Jason T. Slyer
Abstract: Background: Patient-centered self-care education is an educational approach that employs meaningful, targeted education tailored to an individual patient's needs, preferences, and values. Patient-centered educational approaches may empower patients with heart failure to be successful in self-care management and improve outcomes. Objective: To evaluate the effectiveness of patient-centered self-care education for adults with heart failure on knowledge, self-care behaviors, quality of life, and readmissions. Inclusion criteria: Types of participants: Adult patients, 18 years and older, with a diagnosis of heart failure. Types of interventions: All types of patient-centered, self-care education interventions for adult patients with heart failure provided by any health care provider. Types of outcomes: Heart failure knowledge, heart failure self-care behaviors, heart failure-related quality of life, heart failure admissions or readmissions within one-year post intervention. Types of studies: Randomized controlled trials. Search strategy: The search strategy aimed to find relevant published and unpublished studies in the English language between January 1990 and July 2013. Several electronic databases were searched: CINAHL, Pubmed, PsychINFO, EMBASE, CENTRAL, ERIC, Scopus, and DynaMed. A search for gray literature was also performed. Methodologic al quality: Two reviewers evaluated the included studies for methodological quality using standardized critical appraisal instruments from the Joanna Briggs Institute. Data collection: Data were extracted using a standardized data extraction instrument from the Joanna Briggs Institute. Data synthesis: Due to clinical heterogeneity between included studies, statistical meta-analysis was not possible. Results are presented in a narrative form. Results: A total of seven articles describing five randomized controlled trials and one pseudo-randomized trial were included. Four studies demonstrated reduced readmissions with only one reaching statistical significance at six months follow-up (11.4% intervention, 44.2% control, P=0.01). Five studies demonstrated an improvement in quality of life with only one reaching statistical significance between baseline and 12 months follow-up (P=0.002). One study measured knowledge and demonstrated a statistically significant improvement at the 12 months follow-up (P=0.05). One study measured self-care and demonstrated a statistical significant improvement among the intervention group at one month (P < 0.001) and three months (P=0.005) compared with the control. These statistical significant findings indicate the positive effects of the intervention by demonstrating an improvement in outcomes as measured by patients experiencing a more productive quality of life, an increase in heart failure-related knowledge, improved self-care behaviors, and decreased readmission rates post intervention. Conclusions: Patient-centered self-care education for adult patients with heart failure may have a positive benefit in reducing heart failure readmissions and improving heart failure-related knowledge, self-care behaviors, and quality of life. Factors that may influence outcomes include a multidisciplinary team approach and reinforcement of individualized advice with emphasis during care transitions.
Keywords: Heart failure; patient education; patient-centered care; readmission; self-care; heart failure knowledge; quality of life
Rights: Copyright status unknown
DOI: 10.11124/jbisrir-2014-1438
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