Nurses as educators in the comprehensive heart failure care programme-Are we ready for it?

Nurses' knowledge of heart failure assessment and management: A cross-sectional survey

BACKGROUND

Nurses' knowledge of heart failure (HF) is highly variable, ranging from expert to poor, potentially leading to inadequate self-care.

OBJECTIVES

(1) document the knowledge variation of HF assessment and management among specialist and generalist nurses; (2) determine factors that may be associated with nurses' knowledge; and (3) describe nurses' views of knowledge deficits and ways to improve nurses' knowledge to better meet the needs educational interventions.

METHOD

Members of the American Association of Heart Failure Nurses and Registered Nurses were invited to participate in a cross-sectional survey. Independent samples t-test, chi-square, and linear regression were used for quantitative analysis. Text analysis was applied to analyze the themes of qualitative comments.

RESULTS

A total of 918 nurses completed the survey. Specialist nurses had higher scores than generalist nurses with statistically significant F-test for diet, fluid, signs/symptoms, medication, and exercise. Both specialist and generalist nurses were least knowledgeable about dry weight, asymptomatic hypotension, and transient dizziness. Being a specialist nurse was associated with higher level of knowledge scores. Years of experience and race were significant factors associated with knowledge scores in generalist nurses. Confidence level and race were significant predictors for specialist nurses. Three themes emerged regarding the cause of nurses' insufficient knowledge and several approaches were provided.

CONCLUSIONS

Specialist nurses are not only knowledgeable, but their knowledge levels are less variable compared to generalist nurses. There is a need to identify additional factors that may potentially influence nurses' knowledge, contributing to the effectiveness of interventions.

Polish Nurses’ Knowledge of Heart Failure Self-Management Principles

Background: Only comprehensive care and structured education can have a significant impact on the effectiveness of treatment and prepare patients for self-care. Unfortunately, Polish nurses are not ready to perform comprehensive heart failure (HF) care tasks without careful preparation.The purpose of the study was to evaluate nurses’ knowledge of patient education in general and topic-specific perceptions of basic information important for HF self-care, and also to determine the variables (workplace, education, internship) that may affect the implementation of educational tasks in the care of patients with HF. Methods: The study involved 304 nurses who were surveyed using the Nurses’ Knowledge of Heart Failure Education Principles. Results: Cardiology nurses’ knowledge regarding patient education for self-care is insufficient. The overall knowledge score was the highest among nurses in provincial specialist hospitals and university hospitals and the lowest in regional hospitals in small towns (14.98 vs. 14.35 vs. 12.83 vs. 11.89, respectively). Nurses who completed a cardiological specialty demonstrated significantly more extensive knowledge than those who had completed other specialties (15.52 vs. 13.71). Conclusions: Cardiology nurses’ knowledge of HF self-care principles regarding patient education is satisfactory, but not with all mandatory issues, especially in the recognition of disease symptoms, exacerbations, and pharmacotherapy.

Investigating the effect of multimedia education in combination with teach-back method on quality of life and cardiac anxiety in patients with heart failure: a randomized clinical trial

BACKGROUND

Education can contribute to promotion of the quality of life and reduction of heart anxiety in patients with heart failure, so it is important to find a suitable educational method for these patients. Therefore, the present study was an attempt to determine the effect of multimedia education using teach-back method on the life quality and cardiac anxiety in patients with heart failure.

METHODS

The present study was a randomized clinical trial. 120 patients with heart failure class I to III and aged less than 60 years old were selected using sequential sampling; then, they were assigned randomly into two intervention groups and one control group. Group A (multimedia education), group B (education using multimedia together with teach-back method), and group C (control). The quality of life and cardiac anxiety were evaluated in the participants of the three groups before, after, 1 month, and 3 months after the intervention. Data were analyzed using descriptive tests, Pearson correlation, Kolmogorov-Smirnov, chi square and ANOVA test in SPSS 22. The significance level was set at P < 0.05.

RESULTS

No significant differences were found in the mean scores of the quality of life and cardiac anxiety in the control and two intervention groups before the educational intervention. However, immediately after, 1 month and 3 months after the educational intervention, a significant difference was observed between the mean scores of the quality of life and cardiac anxiety in the intervention groups (P < 0.05).

CONCLUSION

Multimedia education together with Teach-Back method is effective in promoting the quality of life and reducing cardiac anxiety in patients with heart failure. Therefore, it is recommended that health policymakers should use this educational method in providing treatment programs.

IRANIAN REGISTRY OF CLINICAL TRIALS

20190917044802N1. Registration date: 5/2/2020.

A qualitative study of nurses' experiences of self-care counseling in migrant patients with heart failure

Objectives

This study aims to enhance researchers’ and nurses’ understanding of how to best support migrant patients with heart failure in self-care management. Previous research on self-care in heart failure patients has highlighted its importance, particularly among migrant populations. Nurses play an important role in informing and engaging patients with chronic conditions like heart failure to support their active participation in self-care. However, nurses’ experiences of providing self-care counseling to migrant populations with heart failure have not been studied.

Methods

A qualitative study was conducted. Nurses working with migrant patients with HF (n = 13) from different types of facility in Western Sweden were interviewed between October and December 2020. Data were collected using semi-structured interviews and analyzed using inductive thematic analysis.

Results

The main theme that emerged from the interviews was the difficulty for nurses “to find balance” in self-care counseling. The nurses during self-care counseling had: “to accept challenges,” “to use creative strategies,” faced “problems related to health literacy,” and “to work according to their (the nurses’) obligations.” It was evident that nurses faced several challenges in counseling migrants in self-care, including language and cultural barriers, time resource constraints, low levels of health literacy, and experienced disharmony between the law and their professional norms. They perceived building caring relationships with their patients to be crucial to fostering health-promoting self-care processes.

Conclusions

To increase self-care adherence, nurses must become more sensitive to cultural differences and adapt self-care counseling to patients’ health literacy. The findings of this research support and challenge nurses in providing the best counsel to migrant patients with heart failure living in Sweden’s multi-ethnic society. Policymakers in the health care organization should act to facilitate mutual cultural understanding between all involved partners for patient-safe self-care counseling.