Heart failure’s context exemplifies the important role played by nurses in addressing social and health care challenges that confront aging populations. Heart failure (HF) is a common phenomenon throughout the world. Over two million patients in Japan, five million individuals in the US, and six million patients in Europe suffer from HF (Boisvert et al., 2015). Moreover, nearly one million people are diagnosed with the disease every year globally. The illness is further associated with an increase in the prevalence of various comorbidities and chronic conditions. Accordingly, cases of HF are complex and include an elevated risk of hospital admissions. Studies have shown that clinical follow-ups and patients’ self-care are among the most successful strategies for managing HF (Zamanzadeh et al., 2012; Navidian et al., 2015). Typically, self-care involves several health-related behaviors that are influenced by environmental, social, and individual factors (Yancy et al., 2013). As such, developing nursing interventions that target the patients’ needs demands rigorous evaluations of strategies designed to optimize self-care practices. In the present review, past studies were examined in order to identify nursing interventions that promote self-care. Although numerous investigations have been conducted to investigate nursing interventions in the management of HF (Hajduk et al., 2013; Linn et al., 2016), few studies have focused on the identification of key aspects of interventions that promote the optimization of self-care among patients. Accordingly, the current study aimed at determining the major features of such nursing approaches. The review’s central question was: “Which characteristics of nursing intervention promote self-care behaviors among patients with HF?” As such, the investigation hypothesized that nursing interventions have key attributes that facilitate the optimization of self-care among HF patients.
Methodology
The current review employed four key steps: problem identification; literature search; evaluation of data; and the reporting and analysis of data. Problem identification employed the PICO method to define population as ‘patients with HF’ and nursing interventions as ‘methods that nurses utilize to promote self-care.’ Thus, the identified problem involved the determination of nursing interventions’ attributes that ameliorate self-care among patients with HF. A literature search was carried out in CINAHL and PubMed databases with a focus on articles published since 2012. The search used a combination of the keywords ‘nursing intervention,’ ‘self-care,’ and ‘heart failure.’ During the third step, data was evaluated by discarding duplicate articles and reviewing abstracts for relevant content. Finally, data was analyzed using a research tool that comprised four items: data concerning article information; description of interventions; targeted practices of self-care; and clinical endpoints.
Results and Discussion
Each of the reviewed studies highlighted nursing interventions based on counseling or educational activities. In one of the studies, Riegel et al. (2012) pointed out that self-care behaviors may be classified into managing, monitoring, and maintenance behaviors. Since nursing interventions target several behaviors, self-care planning can be complex (Hajduk et al., 2013; Da Conceição et al., 2015). Nevertheless, most self-care strategies target behaviors involving the maintenance and monitoring of health whereas few interventions focus on management behaviors. The reviewed studies noted that lifestyle should be the primary outcome because behavior changes are the main goals of nursing intervention (Navidian et al., 2015; Linn et al., 2016). In addition, clinical outcome as an endpoint is equally important because changes in behavior are designed to improve clinical profiles. Nonetheless, the complexity of nursing interventions requires a thorough evaluation of clinical endpoints, which include the assessment of behavioral changes and the effect of self-care behaviors on psychosocial or clinical outcomes. For example, Navidian et al. (2015) found that self-care behavior instruction had minimal effects on depressed HF patients. Thus, there is a need for nurses to consider psychological issues like depression before providing behavior education to HF patients. Additionally, Zamanzadeh et al., (2012) found that patients with HF often failed to adopt recommended self-care behaviors. The researchers, therefore, underscored the need for nurses to employ appropriate strategies for empowering HF patients.
Conclusion
The present review has supported the theory that nursing interventions have various attributes that facilitate the optimization of self-care among HF patients. The identified characteristics include the endpoints used to assess the intervention and the targeted behaviors of self-care. Furthermore, the study has shown that proposed interventions are complex and diverse. However, the majority of such strategies employ educational approaches that emphasize behavior change. In particular, they target self-care behaviors that promote the stability of clinical profiles. As such, the findings of the present review may prove beneficial for nurses involved in the promotion of self-care behaviors among HF patients.
References
Boisvert, S., Proulx-Belhumeur, A., Gonçalves, N., Doré, M., Francoeur, J., & Gallani, M. C. (2015). An integrative literature review on nursing interventions aimed at increasing self-care among heart failure patients. Revista Latino-Americana de Enfermagem, 23(4), 753–768. doi:10.1590/0104-1169.0370.2612.
Da Conceição, A. P., dos Santos, M. A., dos Santos, B., & da Cruz, D. de A. L. M. (2015). Self-care in heart failure patients. Revista Latino-Americana de Enfermagem, 23(4), 578–586. doi:10.1590/0104-1169.0288.2591.
Hajduk, A. M., Lemon, S. C., McManus, D. D., Lessard, D. M., Gurwitz, J. H., Spencer, F. A., & Saczynski, J. S. (2013). Cognitive impairment and self-care in heart failure. Clinical Epidemiology, 5, 407–416. doi:10.2147/CLEP.S44560.
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Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey, D. E., Drazner, M. H.,& Wilkoff, B. L. (2013). 2013 ACCF/AHA guideline for the management of heart failure: A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation, 128(16), e240-e327. doi:10.1161/CIR.0b013e31829e8776.
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