A Nurse-led Health Coaching Intervention for Heart Failure Self-care Management

Summary

There is an increase in Heart Failure (HF) hospitalizations and readmissions despite medical advances (Desai \& Stevenson, 2012; Ambrosy et al.,2014) and in spite of the education provided to HF patients regarding the signs of fluid accumulation, HF exacerbations persist. Unfortunately, there seems to be a gap between patients recognizing these signs of fluid accumulation and performing timely self-management activities to control it. Currently, there is no standardized approach for the delivery of a nurse-led health coaching intervention to assist patients to engage in HF symptom management with self-care activities within a Primary Health Care (PHC) setting. To address this gap, the aim of this research is to examine the feasibility, acceptability, and initial effectiveness of a nurse-led health coaching intervention, involving a self-care activity of the Adjusted Diuretic Dosing (ADD) tool with stable HF patients and their significant others a PHC approach and within a PHC setting.

In the proposed study, nurses will engage with health coaching and a health coaching tool (developed in Phase 1 of this research with the assistance of nurses working in this area) to assist the patient to identify barriers to self-care and develop the patient's goals to successfully engage in HF self-care strategies. It is also necessary for the nurse to capture through documentation what decision-making strategies the nurse performed to assist the patient with HF management. It is through these decision-making points, identified strategies can be examined by the researcher to determine what care gaps or process has occurred. Also, It is through the awareness of the patient's knowledge, skills, past experience, and values and beliefs, those daily decisions will be made by the patient, e.g., decisions will be influenced by the interactions among the person, the problem, and setting or environment - they are situation-specific (Riegel et al., 2016). It is expected that through this kind of naturalistic decision-making process the patient's self-confidence will increase to take action towards maintaining HF self-care activities (such as medication and diet adherence, and weight monitoring), respond to the perception of HF symptoms (seeking medical attention), and be supported to manage their HF condition (adjusting diuretics in response to fluid retention); this to support improved health outcomes and quality of life.

Conditions

• Heart Failure

Interventions

BEHAVIORAL

Nurse-led health coaching re: heart failure self-care management

A focus group meeting will be arranged with the nurse participants to provide training on the study intervention specific to the Nurse-led health coaching intervention. The intervention involves identifying barriers and finding strategies and solutions to self-care management, while employing a self-care HF management tool of adjusting diuretic dosing (ADD) according to the congestive cardiac calendar (designed in collaboration with nurses in Phase 1). It will be essential for the nurses to document key information pertaining to the rationale for these decision-making strategies or solutions. This is in comparison to the standard of care in primary health care of nurses not taking a standardize approach towards health coaching and the patient being instructed by the practitioner to take a set diuretic dosing (SDD).

Sponsors & Collaborators

• Western University, Canada

  lead OTHER

Principal Investigators

• Victoria Smye, PhD · Western University

Study Design

Allocation

NA

Purpose

SUPPORTIVE_CARE

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2022-04-30

Primary Completion

2022-07-31

Completion

2022-07-31