Case Control Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2019; 7(16): 2165-2175
Published online Aug 26, 2019. doi: 10.12998/wjcc.v7.i16.2165
Application of self-care based on full-course individualized health education in patients with chronic heart failure and its influencing factors
Jing Sun, Zhi-Wei Zhang, Yue-Xian Ma, Wei Liu, Chun-Ying Wang
Jing Sun, Zhi-Wei Zhang, Yue-Xian Ma, Department of Nursing, the Second Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, Heilongjiang Province, China
Wei Liu, Chun-Ying Wang, Department of Cardiovascular, the Second Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, Heilongjiang Province, China
Author contributions: Sun J, Zhang ZW, Ma YX, and Liu W designed this work, collected and interpreted the data, and drafted the manuscript; Wang CY designed this work, critically revised the manuscript, and performed overall supervision; all authors contributed to the final approval and accountability for the manuscript.
Supported by the Program of Qiqihar Science and Technology Plan, No. SFGG-201534.
Institutional review board statement: This study was reviewed and approved by the Second Affiliated Hospital of Qiqihar Medical University Institutional Review Board Committee.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: No conflict of interesting.
STROBE Statement: The authors have read the STROBE statement Checklist, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Chun-Ying Wang, MBChB, Chief Nurse, Department of Cardiovascular, The Second Affiliated Hospital of Qiqihar Medical University, No. 37 Zhonghua West Road, Jianhua District, Qiqihar 161000, Heilongjiang Province, China. sjwcy0312@outlook.com
Telephone: +86-452-2739718 Fax: +86-452-2739718
Received: March 28, 2019
Peer-review started: March 28, 2019
First decision: May 31, 2019
Revised: June 24, 2019
Accepted: July 27, 2019
Article in press: July 27, 2019
Published online: August 26, 2019
Processing time: 151 Days and 16.7 Hours
ARTICLE HIGHLIGHTS
Research background

Chronic heart failure (CHF) disease, as a chronic disease, has certain progressive characteristics. Although conventional medication alone can delay the progression of the disease, it often fails to achieve full recovery. Therefore, the current clinical practice is that it can be treated with drugs, but it cannot be cured. This also shows that the addition of scientific nursing intervention on the basis of treatment has important auxiliary significance. The self-care based on full-course individualized health education is a comprehensive nursing measure born in this context. It can make scientific, professional, and individualized health guidance for the patients throughout the whole process, so that patients can form a positive self-care behavior concept, develop a sense of self-care and enables themselves to delay further the disease progression through daily intervention, thus contributing to the improvement of life quality.

Research motivation

At present, there is no unified comprehensive nursing intervention for long-term service of patients with CHF. Although some reports have introduced some nursing interventions, the pertinence and self-participation are not strong, and it is difficult to significantly improve the actual condition of patients. The motivation of this study is to support better the patient's clinical treatment process through self-care based on full-course individualized health education and integrate the nursing intervention into the clinical treatment process, so as to exert more obvious therapeutic effects, help control the condition, and improve the state of life of the patients.

Research objectives

The goal of this study is to explore the application of a new type of nursing intervention - self-care based on full-course individualized health education - in patients with CHF in order to extend this nursing intervention to the clinical treatment of hospitals at all levels. At present, the core concept of initial nursing intervention has been formed. If it is expanded and promoted in depth, it can make a positive contribution to the prognosis and survival of patients with CHF.

Research methods

A total of 100 patients with CHF in the Cardiology Department were selected for the study. The patients in the control group received the existing CHF routine nursing in our hospital. The patients in the intervention group received the self-care based on full-course individualized health education. After 6 mo of follow-up, 6-min walking distance, self-care behavior score, and SF-36 score were compared, and the influencing factors of patient self-care were analyzed.

Research results

The study found that after applying the self-care based on full-course individualized health education, the patient's 6-min walking distance was longer, and the self-care behavior score and SF-36 score were better. At the same time, logistic regression analysis found that the factors affecting patients' self-care mainly include age, cardiac function classification, and education level. Therefore, the clinical application of self-care based on full-course individualized health education can better improve the overall life quality and clinical prognosis of patients. At the same time, scientific interventions based on age, cardiac function classification, and cultural level are targeted to promote better the patient's self-care effect. However, how to implement it in detail is one of the problems to be solved in the future.

Research conclusions

The new findings of this study are mainly that the self-care based on full-course individualized health education can better assist clinical treatment and can achieve therapeutic effects similar to treatment by intervening in the overall behavior of patients. The new theory proposed in this study is mainly the construction and content exploration of self-care based on full-course individualized health education, which is expected to provide more clearly theoretical ideas for future nursing interventions. The appropriate summary of the current knowledge provided by this study is that self-care based on full-course individualized health education has an important role and has a positive impact on patients. The original insight is that the self-care based on full-course individualized health education can achieve a certain level of nursing intervention, which may be similar to conventional care, or better. The new hypothesis is that the self-care based on full-course individualized health education may be a new type of care for patients with CHF. The new method proposed in this study is mainly the formulation and implementation of the self-care based on full-course individualized health education. The new phenomenon found in this study was that the effect of self-care based on full-course individualized health education was better than expected, and it also contributed to the improvement of patients' quality of life. The hypothesis confirmed through experiments in this study is that the self-care based on full-course individualized health education has a better clinical prognosis for patients. The implications of this study for clinical practice in the future is that the content of self-care based on full-course individualized health education can be further optimized or expanded, so as to enrich better the theoretical knowledge system and ultimately better serve CHF patients.

Research perspectives

From this study, we can learn that the self-care based on full-course individualized health education is conducive to the patient's condition symptom control and quality of life. A limitation of the study is that the sample size is relatively small. Future research directions include attempts to expand sample size, conduct multi-center research, and further extend follow-up time while expanding the care content system. The best method for the future research is to conduct a stratified study of large sample sizes or a simultaneous study of multi-level medical institutions to obtain more accurate results and conclusions.