Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Author:
Kroustalli Elpida
Dissertation committee:
Νανάς Σεραφείμ, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κοτανίδου Αναστασία, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ρούτση Χριστίνα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Καλοκαιρινού Αθηνά, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Φιλίππου Αναστάσιος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Βασιλειάδης Ιωάννης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Ροβίνα Νικολέττα, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Εκπαίδευση ασθενών με καρδιακή ανεπάρκεια και ο ρόλος της στη συμμόρφωσή τους στη θεραπεία και στην ποιότητα ζωής.
Translated title:
The role of educating patients with heart failure and their compliance in therapy and quality of life.
Summary:
Background/Introduction: Despite published guidelines emphasizing the importance of education in management of Heart Failure (HF), the most effective method of educating remains unknown.
Purpose: The purpose of this study was to test the efficacy of Constructivist Teaching Method (CTM) on the patients with HF.
Methods: This is a single-center, randomized controlled trial. Patients in the intervention group were educated using the CTM in five phases: orientation, elicitation, restructuring, application and review. For the study outcome measures of five questionnaires were used: Atlanta Heart Failure Knowledge Test (AHFKT), Minnesota Living with Heart Failure (MLHFQ), Self-Efficacy for Appropriate Medication Use Scale (SEAMS), European Heart Failure Self-care Behaviour Scale (EHFScBS-9), Duke Activity Status Index (DASI).
Results: A total of 122 adults (83.6% male, mean age ±SD 67.1±12.3 years) were enrolled in the study; 61 in the intervention group and 61 in the control group. The two groups were similar in terms of age, educational level and disease status. Concerning knowledge as measured with Atlanta-HF-Knowledge-Test there was a significant improvement in both control and intervention group but the degree of improvement was greater in the intervention group (p<0.001). Minnesota dimensions for quality of life were also significantly improved in both study groups but at 6 months the intervention group reached better levels at both physical and emotional subscales (p<0.001). Furthermore, adherence to treatment and dimensions of Adhering to recommendations, Fluid and sodium management, Physical activity and recognition of deteriorating symptoms were improved in both groups but the degree of change was greater in the intervention group as indicated from the results of repeated measurements ANOVA (p<0.001). The Duke Activity Status Index (DASI) was improved only in the intervention group (p<0.001) and no significant change was found in the control group (p=0.455). Significantly lower proportion of readmission at hospital at one month (8.2% vs.24.6%, p=0.014) and six months (3.3% vs.19.7%, p=0.005) were found for the intervention group.
Conclusions: These data support the use of an intervention with CTM to improved clinical outcomes. This study will be an important step in creating an evidence base for the relative benefits of different educational strategies for management of HF.
Main subject category:
Health Sciences
Keywords:
Heart Failure, Constructivist Teaching Method
