Paper
Wednesday, 19 July 2006
This presentation is part of : Strategies for Care of the Chronically Ill
Sensory Preparatory Training Promotes Self Management Skills in Heart Failure
Linda Baas, PhD, CS-ACNP, College of Nursing, University of Cincinnati, Cincinnati, OH, USA
Learning Objective #1: Identify how sensory preparatory training can increase awareness of symptoms.
Learning Objective #2: Describe the outcomes of a sensory preparatory training program on outcomes in persons with heart failure.
Self-management is a goal in the treatment of persons with heart failure (HF) but education alone is not successful. Leventhal theorized that teaching sensory along with factual information can decrease stress and improve outcomes. Johnson developed sensory preparatory training (SPT) for patients undergoing acute stressful procedures. The purpose of this pilot was to refine and evaluate a SPT program of self-management in a chronic setting with patients with symptomatic HF. The sample was married (41%), retired/disabled (65%), female (67%), Caucasian (65%) with some college (70.6%), and age 59 (sd ± 11) years. Two groups completed the SPT program; one group attended 4 weekly meetings (n=4), the other 6 (n=13). Each 2-hour class included information on HF or treatments along with body awareness exercises. Subjects kept logs of symptoms and weight, and completed surveys pre, post and at 2 month follow-up of the SPT. Self-management skills and self-efficacy as measured by the Self-Care HF Scale significantly (p<.05) improved after SPT with a slight drop off at 2 months. The stress visual analog scores significantly decreased post intervention with an increase at follow-up.  Monitoring style of coping was related to a lower level of stress post intervention (r= -.52). Self-efficacy and stress were inversely related at the 2 month follow up (r = -.635). Over the study, 5 subjects became asymptomatic despite the severe nature of the HF while only 3 became more symptomatic. All subjects strongly agreed that they gained skill in body awareness, early symptom recognition, and self-care. Conclusion: While self-efficacy and self-care actions increased with the SPT intervention these effects did decline at follow up. This may be due to fading of the intervention over time, the absence of group support, and/or the increased perception of stress. This study supports the need for a larger trial.

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