The Development and Evaluation of the Self-care Enhancement Model for Patients with Heart Failure, Vachira Phuket Hospital

Abstract

This research and development study aims to develop the Self-care Enhancement Model for Patients with Heart Failure (ScEM-HF) and evaluate after implementing the model at the Heart Failure (HF) Clinic, Vachira Phuket Hospital. The outcomes included (1) clinical outcomes (readmission, presence of volume overload, stress), (2) intermediate outcomes (HF self-care and HF self-care knowledge), and (3) satisfaction with the ScEM-HF. The study was conducted in 4 stages: Stage 1-situational analysis and examining information related to HF self-care, Stage 2-development of the ScEM-HF, Stage 3-implementing and evaluating the ScEM-HF, and Stage 4-modifying the ScEM-HF and recommendation.
The participants were 26 HF patients who attended the HF clinic, recruited according to the
inclusion criteria, 6 personnel in the multidisciplinary team, and 15 health volunteers. Of these respective participants, 13, 6, and 5 participated in the interview sessions during the
first stage. The study instruments were examined for validity and reliability. Qualitative data were analyzed using the content analysis technique. Pre-implementation quantitative data were compared with those of post-implementation using McNemar test and Wilcoxon Signed
Rank test. The results indicated that the clinical outcomes improved significantly. The heart
failure self-care subscale scores and the overall heart failure knowledge scores increased
significantly. The multidisciplinary team’s and health volunteers’ satisfaction significantly
increased; while the patients’ satisfaction showed an increasing trend although it was not significantly different. Continuous improvement and implementation of the developed ScEM-HF is recommended.