Paper
Wednesday, July 11, 2007
Shared Medical Visits in the Heart Failure Population: Knowledge, Self-Care, and Health-Related Quality of Life
Karen Yehle, MS, APRN, BC, Nursing, Purdue University, West Lafayette, IN, USA
| Learning Objective #1: describe components of a shared medical visit for patients diagnosed with heart failure. |
| Learning Objective #2: describe a shared medical visit for the heart failure population related to the outcomes of knowledge, self-care, and quality of life. |
Objective: To compare Shared Medical Visit Model with usual care in the heart failure population.
Design: A longitudinal experimental research design was utilized for this study.
Sample: The sample consisted of 52 participants diagnosed with heart failure (intervention group n=24, control group n=28).
Outcome Variables: Knowledge, self-care, and health-related quality of life.
Methods: After IRB review, patients diagnosed with heart failure were recruited in an outpatient setting to participate in the study. After consent, participants were randomized to the intervention or control group. The control group received usual care with the nurse practitioner at their regularly scheduled appointment (e.g. every 8 weeks). The intervention group saw the nurse practitioner individually during their regularly scheduled visit and received 60 minutes of group education and support from the nurse practitioner and an advanced practice nurse immediately before or after their individual appointment. Data were collected with each group at baseline, 8 weeks, and 16 weeks, using the Heart Failure Knowledge Test (HFKT), Self-Care Heart Failure Index (SCHFI), and Chronic Heart Disease Index Questionnaire Self-Administered Individualized Format (CHQ-SAI).
Findings: Scores on the HFKT improved significantly more for the intervention (n=13) group compared to the control (n=10) group (F timeXgroup= 4.90, df=1,21; p=.038) from baseline to eight weeks. Scores on the SCHFI maintenance subscale improved significantly more for the intervention (n=14) group compared to the control (n=11) group (F timeXgroup= 4.66, df=1,23; p=.042) from baseline to eight weeks. The intervention group did not improve significantly more than the control group on the CHQ-SAI.
Conclusions: Follow-up care that includes an individual check-up and an educational session resulted in improved knowledge and self-care among heart failure patients.
Implications: Shared Medical Visits may be an important tool for increasing knowledge and compliance among patients diagnosed with heart failure.