Randomized study of the effect of video education on heart failure healthcare utilization, symptoms and self-care behaviors

Division of Nursing and George M. and Linda H. Kaufman, Center for Heart Failure, The Cleveland Clinic Foundation, Cleveland, USA.
Patient Education and Counseling (Impact Factor: 2.2). 01/2008; 69(1-3):129-39. DOI: 10.1016/j.pec.2007.08.007
Source: PubMed


Adherence to self-care behaviors improves heart failure (HF) morbidity and life quality. We examined short-term impact of video education (VE) in addition to standard education (SE) on HF healthcare utilization and self-care behavior adherence.
One hundred and twelve hospitalized patients were randomly assigned to SE (n=53) or SE plus VE (n=59). Differences between groups were analyzed in patients who underwent 3-month follow-up (39 SE and 37 VE patients). Mean age was 60+/-14 years; mean HF length was 57 months.
Three-month healthcare utilization was similar between groups but VE patients needed less extra diuretic dosing (P<0.02), received more HF literature (P<0.03), and had less healthcare team telephone communication (P<0.04). VE patients had greater sign/symptom reduction (P<0.04); especially related to edema (P<0.01) and fatigue (P<0.01) and initiated more actions for edema (P<0.05) and dyspnea (with exercise or rest, both P<0.01). Overall, VE patients had a higher mean self-care behavior score (P<0.01), reflecting greater self-care adherence.
Video education prompts self-care behavior adherence to control worsening signs/symptoms of volume overload. During 3-month follow-up, utilization of most healthcare resources was unchanged.
VE is a useful adjunct to in-person education.

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    • "A variety of educational strategies have been implemented consisting primarily of didactic sessions with one-to-one delivery or small group sessions together with written information such as booklets, diaries or pamphlets. Some interventions included multi-media programs such as a CD-ROM [18], video [19], and an interactive internet site [20]. These approaches have often been evaluated differently making it difficult to compare their effectiveness. "
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    ABSTRACT: Heart failure management programs which include education are the gold standard for management of patients with heart failure. Identifying the learning styles and learning needs of heart failure patients is an essential step in developing effective education strategies within these programs. To investigate the learning style and learning needs of heart failure patients. Patients diagnosed with heart failure at a large tertiary referral hospital completed a Heart Failure Learning Style and Needs Inventory. From the total of 55 patients who completed the questionnaire 64% reported a preference for multimodal learning style, 18% preferred read/write, 11% preferred auditory, and 7% preferred kinesthetic. In relation to educational topics, signs and symptoms was ranked as the most important topic to learn about followed by prognosis. This study provides a poignant snap-shot into the world of chronic disease. In essence, the patients' educational needs for living with heart failure can be summed up as "Never better, getting worse, unpredictable". The results indicate that these groups of patients need to know (Need2Know) about information regarding their signs and symptoms as well as wanting to elicit the significance of their disease and whether it can be cured.
    European Journal of Cardiovascular Nursing 07/2009; 8(5):316-22. DOI:10.1016/j.ejcnurse.2009.05.003 · 1.88 Impact Factor

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    ABSTRACT: Despite advances in healthcare, heart failure patients continue to experience complications that could have been prevented or treated. This occurs because the only way that a therapeutic or preventive regimen can be effective, assuming that the patient's condition has been accurately diagnosed and appropriately treated, is if the patient implements self-care behaviors and adheres to the treatment regimen. However, it is widely accepted that this does not occur in many or even most instances. This article provides an overview of the current evidence related to adherence and self-care behaviors among heart failure patients and describes the state of the science on interventions developed and tested to enhance self-care maintenance in this population. Our review of literature shows that effective interventions integrate strategies that motivate, empower, and encourage patients to make informed decisions and assume responsibility for self-care. Gaps in current evidence support the need for additional research on ways to improve adherence and self-care for patients who are at an increased risk of poor adherence, including those with cognitive and functional impairments and low health literacy.
    The Journal of cardiovascular nursing 05/2008; 23(3):250-7. DOI:10.1097/01.JCN.0000317428.98844.4d · 2.05 Impact Factor
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