A considerable number of heart failure patients experience cognitive impairment, and it affect quality of life. This preliminary study attempted to determine the effects of a cognitive training self-management program on cognitive functioning and self-care behavior.
Methods: methods
Twenty-eight patients were assigned to either a cognitive training self-management or waitlist condition. The 12-week cognitive training self-management program consisted with cognitive training and tailed self-care education, and counseling. Cognitive training emphasizes strategies and aims to facilitate adaptive coping and the development of realistic and optimistic attitudes toward cognitive decline. The program individualized face-to-face education through the use of a handbook, paper-and-pencil homework exercises, and telephone-delivered health-coaching sessions. Participants were assessed at baseline (T1), and the completion of the 12-week intervention (T2). Outcomes were assessed using the Montreal Cognitive Assessment (MoCA), the Korean version of the Cognitive Failures Questionnaire (CFQ), the self-Care of Heart Failure Index (SCFHI), and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Data were analyzed using repeated-measures ANCOVA with SPSS 23.0.
Results: results
Mean age of participants were 63.5 years old. Of the patients, 18 were male and 8 were diagnosed as ejection fraction reduced heart failure. When testing the homogeneity of the groups, there were no statistically significant differences between the groups for any of these characteristics and outcomes. In the intervention group, the mean score of CFQ was 27.18 at T1 and 25.00 at T2. The waitlist group showed the mean score of CFQ 28.00 at T1 and 31.87 at T2. Unlike the control group, the intervention group improved subjective cognitive impairment after intervention. According to repeated-measures ANOVA, CFQ of the patients in intervention group considerably reduced compared with control group (F = 5.28; P =.031).
Meanwhile, the mean score of MLHFQ of intervention group was 23.91 at T1 and 18.45 at T2. The waitlist group showed the mean score of MLHFQ 22.93 at T1 and 28.53 at T2. The quality of life of the intervention group was improved after intervention. The intervention group improved significantly over time compared to the waitlist group on the CFQ and MLHFQ scores. The CFQ and MLHFQ scores showed significant group × time interaction. However, there were no significant group × time interaction in the SCFHI and MoCA scores.
Conclusion: conclusion
These results suggest that the 12-week cognitive training self-management program improved the subjective cognitive functioning and disease specific QoL. There is no significant impact on self-management in this study. However, since this study is a preliminary study, it is necessary to continue the study by expanding the target population.