Building skill in heart failure self-care among community dwelling older adults: results of a pilot study.
OBJECTIVE
Most of the day-to-day care for heart failure (HF) is done by the patient at home and requires skill in self-care. In this randomized controlled trial (RCT) we tested the efficacy of a community-based skill-building intervention on HF self-care, knowledge and health-related quality of life (HRQL) at 1- and 3-months.


METHODS
An ethnically diverse sample (n=75) of patients with HF (53% female; 32% Hispanic, 27% Black; mean age 69.9±10 years) was randomized to the intervention group (IG) or a wait-list control group (CG). The protocol intervention focused on tactical and situational HF self-care skill development delivered by lay health educators in community senior centers. Data were analyzed using mixed (between-within subjects) ANOVA.


RESULTS
There was a significant improvement in self-care maintenance [F(2,47)=3.42, p=.04, (Cohen's f=.38)], self-care management [F(2,41)=4.10, p=.02, (Cohen's f=.45) and HF knowledge [F(2,53)=8.00, p=.001 (Cohen's f=.54)] in the IG compared to the CG.


CONCLUSIONS
The skill-building intervention improved self-care and knowledge but not HRQL in this community-dwelling sample.


PRACTICE IMPLICATIONS
Delivering an intervention in a community setting using lay health educators provides an alternative to clinic- or home-based teaching that may be useful across diverse populations and geographically varied settings.
['Dickson|Victoria Vaughan|VV|', "Melkus|Gail D'Eramo|GD|", 'Katz|Stuart|S|', 'Levine-Wong|Alissa|A|', 'Dillworth|Judy|J|', 'Cleland|Charles M|CM|', 'Riegel|Barbara|B|']
D000368:Aged D000369:Aged, 80 and over D003142:Communication D005260:Female D007722:Health Knowledge, Attitudes, Practice D006304:Health Status D006333:Heart Failure D006801:Humans D057187:Independent Living D008297:Male D008875:Middle Aged D010349:Patient Compliance D010353:Patient Education as Topic D010865:Pilot Projects D011788:Quality of Life D012648:Self Care D011795:Surveys and Questionnaires D013663:Teaching
Heart failure Self-care Health educators Symptom monitoring decision-making Treatment adherence