The effectiveness of individual self-testing and self-care skills training programs in chronic heart failure patients
The aim of the study was to evaluate the impact of individual self-control and self-care skills training programs on quality of life, disease severity, frequency and duration of hospitalization in patients with heart failure. 120 patients with heart failure (NYHA classes II–IV, mean age 62.8±9.8 years, ischemic etiology in combination with hypertension) were included into the study. Patients were randomized to three (the 1st, the 2nd and control) groups. In the 1st group patients were trained using individual programs that take into account the level of patients’ health literacy, patients from the 2nd group attended lectures, patients from the control group were not trained. The duration of observation period was 6 months. The difference in frequency and duration of hospitalization was revealed between the 1st and the control group. Positive dynamics of the functional status of patients from the 1st and the 2nd groups was detected. 80 % patients from the 1st group improved their heart failure NYHA class, 25 % from the 2nd, 7.5 % from the control group. In the 1st and the 2nd groups heart failure symptoms improvement was revealed, the 6-minute walk test distance was increased (from 283.6±112.2 to 395.9±80.6 m, Р<0.001 in the 1st and from 273.5±94.6 to 302.6±94.9 m, Р<0.001 in the 2nd), and this distance was greater in the 1st group (Р<0.01 compared with the 2nd). The quality of patients’ life also improved in the 1st and the 2nd groups (on 15.6±12.0 and 7.0±7.6 points of the Minnesota Living with Heart Failure Questionnaire respectively, Р<0.001 compared with baseline). Thus, individual self-control and self-care skills training programs that took into account the level of patients’ health literacy in heart failure were more effective than group sessions, and could improve quality of life, reduce the severity of heart failure, the frequency and duration of hospitalization.