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Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia

BACKGROUND: As the burden of cardiovascular disease increases in sub-Saharan Africa, there is a growing need for low-cost interventions to mitigate its impact. Providing self-care health education to patients with chronic heart failure (CHF) is recommended as an intervention to prevent complications...

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Autores principales: Dessie, Getenet, Burrowes, Sahai, Mulugeta, Henok, Haile, Dessalegn, Negess, Ayenew, Jara, Dubie, Alem, Girma, Tesfaye, Bekele, Zeleke, Haymanot, Gualu, Tenaw, Getaneh, Temsgen, Kibret, Getiye Dejenu, Amare, Desalegne, Worku Mengesha , Endalkachew, Wagnew, Fasil, Khanam, Rasheda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336108/
https://www.ncbi.nlm.nih.gov/pubmed/34344316
http://dx.doi.org/10.1186/s12872-021-02170-8
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author Dessie, Getenet
Burrowes, Sahai
Mulugeta, Henok
Haile, Dessalegn
Negess, Ayenew
Jara, Dubie
Alem, Girma
Tesfaye, Bekele
Zeleke, Haymanot
Gualu, Tenaw
Getaneh, Temsgen
Kibret, Getiye Dejenu
Amare, Desalegne
Worku Mengesha , Endalkachew
Wagnew, Fasil
Khanam, Rasheda
author_facet Dessie, Getenet
Burrowes, Sahai
Mulugeta, Henok
Haile, Dessalegn
Negess, Ayenew
Jara, Dubie
Alem, Girma
Tesfaye, Bekele
Zeleke, Haymanot
Gualu, Tenaw
Getaneh, Temsgen
Kibret, Getiye Dejenu
Amare, Desalegne
Worku Mengesha , Endalkachew
Wagnew, Fasil
Khanam, Rasheda
author_sort Dessie, Getenet
collection PubMed
description BACKGROUND: As the burden of cardiovascular disease increases in sub-Saharan Africa, there is a growing need for low-cost interventions to mitigate its impact. Providing self-care health education to patients with chronic heart failure (CHF) is recommended as an intervention to prevent complications, improve quality of life, and reduce financial burdens on fragile health systems. However, little is known about health education’s effectiveness at improving CHF self-management adherence in sub-Saharan Africa. Therefore the present study aimed to assess the effectiveness of an educational intervention to improve self-care adherence among patients with CHF at Debre Markos and Felege Hiwot Referral Hospitals in Northwest Ethiopia. METHODS: To address this gap, we adapted a health education intervention based on social cognitive theory comprising of intensive four-day training and, one-day follow-up sessions offered every four months. Patients also received illustrated educational leaflets. We then conducted a clustered randomized control trial of the intervention with 186 randomly-selected patients at Debre Markos and Felege Hiwot referral hospitals. We collected self-reported data on self-care behavior before each educational session. We analyzed these data using a generalized estimating equations model to identify health education's effect on a validated 8-item self-care adherence scale. RESULTS: Self-care adherence scores were balanced at baseline. After the intervention, patients in the intervention group (n = 88) had higher adherence scores than those in the control group (n = 98). This difference was statistically significant (β = 4.15, p < 0.05) and increased with each round of education. Other factors significantly associated with adherence scores were being single (β = − 0.25, p < 0.05), taking aspirin (β = 0.76, p < 0.05), and having a history of hospitalization (β = 0.91, p < 0.05). CONCLUSIONS: We find that self-care education significantly improved self-care adherence scores among CHF patients. This suggests that policymakers should consider incorporating self-care education into CHF management. Trial registration number: PACTR201908812642231 SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-021-02170-8.
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spelling pubmed-83361082021-08-04 Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia Dessie, Getenet Burrowes, Sahai Mulugeta, Henok Haile, Dessalegn Negess, Ayenew Jara, Dubie Alem, Girma Tesfaye, Bekele Zeleke, Haymanot Gualu, Tenaw Getaneh, Temsgen Kibret, Getiye Dejenu Amare, Desalegne Worku Mengesha , Endalkachew Wagnew, Fasil Khanam, Rasheda BMC Cardiovasc Disord Research Article BACKGROUND: As the burden of cardiovascular disease increases in sub-Saharan Africa, there is a growing need for low-cost interventions to mitigate its impact. Providing self-care health education to patients with chronic heart failure (CHF) is recommended as an intervention to prevent complications, improve quality of life, and reduce financial burdens on fragile health systems. However, little is known about health education’s effectiveness at improving CHF self-management adherence in sub-Saharan Africa. Therefore the present study aimed to assess the effectiveness of an educational intervention to improve self-care adherence among patients with CHF at Debre Markos and Felege Hiwot Referral Hospitals in Northwest Ethiopia. METHODS: To address this gap, we adapted a health education intervention based on social cognitive theory comprising of intensive four-day training and, one-day follow-up sessions offered every four months. Patients also received illustrated educational leaflets. We then conducted a clustered randomized control trial of the intervention with 186 randomly-selected patients at Debre Markos and Felege Hiwot referral hospitals. We collected self-reported data on self-care behavior before each educational session. We analyzed these data using a generalized estimating equations model to identify health education's effect on a validated 8-item self-care adherence scale. RESULTS: Self-care adherence scores were balanced at baseline. After the intervention, patients in the intervention group (n = 88) had higher adherence scores than those in the control group (n = 98). This difference was statistically significant (β = 4.15, p < 0.05) and increased with each round of education. Other factors significantly associated with adherence scores were being single (β = − 0.25, p < 0.05), taking aspirin (β = 0.76, p < 0.05), and having a history of hospitalization (β = 0.91, p < 0.05). CONCLUSIONS: We find that self-care education significantly improved self-care adherence scores among CHF patients. This suggests that policymakers should consider incorporating self-care education into CHF management. Trial registration number: PACTR201908812642231 SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-021-02170-8. BioMed Central 2021-08-03 /pmc/articles/PMC8336108/ /pubmed/34344316 http://dx.doi.org/10.1186/s12872-021-02170-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Dessie, Getenet
Burrowes, Sahai
Mulugeta, Henok
Haile, Dessalegn
Negess, Ayenew
Jara, Dubie
Alem, Girma
Tesfaye, Bekele
Zeleke, Haymanot
Gualu, Tenaw
Getaneh, Temsgen
Kibret, Getiye Dejenu
Amare, Desalegne
Worku Mengesha , Endalkachew
Wagnew, Fasil
Khanam, Rasheda
Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia
title Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia
title_full Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia
title_fullStr Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia
title_full_unstemmed Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia
title_short Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia
title_sort effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in northwest ethiopia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336108/
https://www.ncbi.nlm.nih.gov/pubmed/34344316
http://dx.doi.org/10.1186/s12872-021-02170-8
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