A motivational counseling approach to improving heart failure self-care: mechanisms of effectiveness

Details

• Personal Author:
  Dickson VV ; Hoke L ; McMahon JP ; Reis BF ; Riegel B ; Sayers S
• Description:
  Background: Self-care is an integral component of successful heart failure (HF) management. Engaging patients in self-care can be challenging. Methods: Fifteen patients with HF enrolled during hospitalization received a motivational intervention designed to improve HF self-care. A mixed method, pretest posttest design was used to evaluate the proportion of patients in whom the intervention was beneficial and the mechanism of effectiveness. Participants received, on average, 3.0 T 1.5 home visits (median 3, mode 3, range 1Y6) over a three-month period from an advanced practice nurse trained in motivational interviewing and family counseling. Quantitative and qualitative data were used to judge individual patients in whom the intervention produced a clinically significant improvement in HF self-care. Audiotaped intervention sessions were analyzed using qualitative methods to assess the mechanism of intervention effectiveness. Results: Congruence between quantitative and qualitative judgments of improved self-care revealed that 71.4% of participants improved in self-care after receiving the intervention. Analysis of transcribed intervention sessions revealed themes of 1) communication (reflective listening, empathy); 2) making it fit (acknowledging cultural beliefs, overcoming barriers and constraints, negotiating an action plan); and, 3) bridging the transition from hospital to home (providing information, building skills, activating support resources). Conclusion: An intervention that incorporates the core elements of motivational interviewing may be effective in improving HF self-care, but further research is needed. [Description provided by NIOSH]
• Subjects:
  Aging Behavior Cardiovascular Diseases Cardiovascular System Demography Education Health Personnel Men Occupational Health Race Factors Respiratory System Safety Sex Characteristics Women

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• Keywords:
  Age-groups Attitude Author Keywords: Heart Failure Cardiac-function Cardiopulmonary-function Cardiovascular-disease Cardiovascular-function Cardiovascular-system Cardiovascular-system-disorders Demographic-characteristics Humans Mixed Methods Motivational Interviewing Naturalistic Decision-making Nurses Patient Education Racial-factors Self-care Sex-factors

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• ISSN:
  0889-4655
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 3 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  232-241
• Volume:
  21
• Issue:
  3
• NIOSHTIC Number:
  nn:20044950
• Citation:
  J Cardiovasc Nurs 2006 May-Jun; 21(3):232-241
• Contact Point Address:
  Dr. Barbara Riegel, School of Nursing, Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA 19104-6096
• Email:
  briegel@nursing.upenn.edu
• Federal Fiscal Year:
  2006
• Performing Organization:
  University of Pennsylvania
• Peer Reviewed:
  True
• Start Date:
  20020701
• Source Full Name:
  The Journal of Cardiovascular Nursing
• End Date:
  20120630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:fff3d9a4b1741b4b82312a6481f9c85402aa93d43b4beb0eb0dcc79c607c8654c0d6d747fdf6898caf419be30ce1f04428a7259a3d37e0d398fb2b6345c8fe0c
• Download URL:
  https://stacks.cdc.gov/view/cdc/200530/cdc_200530_DS1.pdf
• File Type:
  [PDF - 209.40 KB ]