LEARN to co-manage heart failure: implementation of best practice guidelines
McSwiggan, Jane Mary
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Effective treatment of heart disease and an aging population have led to increases in the incidence of heart failure. Treatment requires complex medication regimes and recognition of symptoms. Best practice guidelines published by the American, European and Canadian cardiac societies promote self-care behaviours and skill building. No concrete examples of education programmes for clients were found in the literature. The purpose of the study was to develop, pilot and evaluate an education series for clients with heart failure within a primary care setting. “LEARN twice”, a three part education series with related resource material, was developed in the context of inter-professional collaboration and drew upon theories of health education, and literacy. The concept of co-management was incorporated as the philosophical basis in the design. The pilot-test used an experimental design, and incorporated pre and post-testing with standardized instrumentation including the Dutch Heart Failure Knowledge Scale and the Minnesota Living with Heart Failure Questionnaire. To pilot the education series, participants attended three education classes highlighting the essential skills for self management of heart failure. A qualitative descriptive component included brief semi-structured interviews with participants and educators to provide feedback about both the process and content of the educational series. Limited participant numbers did not permit statistical testing, however potentially promising results were found in the quantitative data collected. Descriptive participant data indicated that the education series was meaningful, and helped iii understanding of symptoms. Instructors rated the content as good to excellent and anticipate the adoption of the education series as standard practice in the clinic. The pilot test of the education series has provided a foundation for future research endeavours, in particular the replication and completion of this study protocol. As clients with heart failure have the potential to be in regular contact with a primary care provider, subsequent studies could include a longitudinal component to examine whether rates of re-hospitalization are reduced for clients who attend an education series.