Research Article: Association between a stepwise health education model based on evidence-based practice and self-care behaviors of patients with chronic heart failure: a single-center retrospective cohort study
Abstract:
This study aims to investigate the association between a stepwise health education model based on evidence-based practice (EBP) and self-care behaviors, cardiac function improvement, and clinical outcomes in patients with chronic heart failure (CHF).
A retrospective analysis was performed on the clinical data of 120 patients with CHF admitted to our hospital from January 2023 to December 2024. The patients were divided into a control group (CG, n =?62, receiving routine health education) and an intervention group (IG, n =?58, receiving stepwise health education based on EBP in addition to routine care) according to the health education strategy received. The 6-month total score of the EHFScB-9 was defined as the primary outcome. Cardiac function indicators (LVEF, BNP, and 6MWD), biochemical indicators, clinical outcomes, individual scale items, and hospitalization-related indicators were considered exploratory outcomes. Factors associated with the occurrence of composite endpoint events were analyzed.
After 6 months of intervention, the IG exhibited significantly higher LVEF and 6MWD and significantly lower BNP level than the CG ( P <?0.05). The serum sodium level in the IG was significantly higher than that in the CG ( P <?0.05). Exploratory analyses showed that the nominal P values for the 30-day, 90-day, and 6-month readmission rates, as well as the incidence of composite endpoint events, were all <0.05 in the IG. The average length of stay and total hospitalization costs in the IG were significantly lower than those in the CG ( P <?0.05); however, these findings were interpreted as exploratory. At the 6-month follow-up, the IG exhibited lower total EHFScB-9 scores and lower scores for individual items than the CG ( P <?0.05), indicating better self-care behaviors. Comparisons of individual items were exploratory findings. Multivariable analysis revealed that NYHA class III-IV (OR?=?3.765), concomitant atrial fibrillation (OR?=?2.440), LVEF?<?40% (OR?=?3.184), and lack of stepwise health education based on EBP (OR?=?2.607) were associated with the composite endpoints.
In this single-center retrospective cohort study, analyses without adjustment for multiple comparisons suggested that a step health education model based on evidence-based practice was associated with better self-care behaviors, improved cardiac function, and lower rates of readmission and composite endpoint events.
Introduction:
Chronic heart failure (CHF) is the end stage of various cardiac diseases and is characterized by decreased cardiac pump function and inadequate cardiac output to meet the body's metabolic demands. It is one of the main causes of death in patients with cardiovascular diseases ( 1 , 2 ). Epidemiological data indicate that the prevalence of heart failure in China is approximately 0.9%, effecting more than 12 million patients ( 3 ). In addition, with the accelerated aging of the population, the incidence of CHF…
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