Development of Heart Failure Self–Management Promotion Model for Patients at Heart Failure Clinic, Sakon Nakhon Hospital

Abstract

          This research and development aimed to develop the heart failure self–management promotion model (HFSMM) for patients in heart failure clinic at Sakon Nakhon hospital and to study its effect after development. The sample consisted of 2 groups; 90 patients with heart failure and 8 professional nurses involved in the care of these patients. This research was conducted with 4 steps; 1) analysis of the problems, conditions, and needs for model development 2) synthesis of knowledge and design of HFSMM 3) trial out the model and 4) evaluation and dissemination. Data were collected from April, 2016 to December, 2017. The research instruments included self–management promotion program, self–management guidelines for patients, self–management manual, data collection form, group discussion and quality of life evaluation form. Data were analyzed using the descriptive statistics; mean, frequency, and percentage and compared the results between the experimental group and the control group using Mann–Whitney U test and Chi–Square test.

         The results revealed that the HFSMM consisted of three parts 1) specialist clinical nurses for heart failure or advanced nurse practitioners served as a clinical nurse–led on a case–by–case, promote self–management in the specified form, coordinated with multidisciplinary teamsto monitor and evaluate patient care and outcome 2) self-management promotion programs included the self–management assessment, self–management education, self–management skills training, self–management motivation and empowerment, and self–management support and 3) 6 steps of patient self–management included the goal setting, information collection, information processing, implementation, evaluation and self–reflection. The results of using the self–management promotion model showed that after receiving this model the experimental groups had significantly differences in functional capabilities, quality of life and the number of hospital admission from those of control group (p <0.05). Therefore, HFSMM should be promoted to implement into the heart failure clinic in the hospital networks together with the expertise development of clinic nurses.
        Keywords: Self–management, Heart failure, Nurse–led, Heart failure clinic