| Effect of Patient Activation on Self-Management in Patients With Heart Failure. | |
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MedLine Citation:
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PMID: 22343209 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND/OBJECTIVE:: Few studies have examined whether chronic heart failure (HF) outcomes can be improved by increasing patient engagement (known as activation) in care and capabilities for self-care management. The objective was to determine the efficacy of a patient activation intervention compared with usual care on activation, self-care management, hospitalizations, and emergency department visits in patients with HF. METHODS:: This study used a randomized, 2-group, repeated-measures design. After consent was given, 84 participants were stratified by activation level and randomly assigned to usual care (n = 41) or usual care plus the intervention (n = 43). The primary outcomes and measures were patient activation using the Patient Activation Measure (PAM), self-management using the Self-Care of Heart Failure Index (SCHFI) and the Medical Outcomes Study (MOS) Specific Adherence Scale, and hospitalizations and emergency department visits. The intervention was a 6-month program to increase activation and improve HF self-management behaviors, such as adhering to medications and implementing health behavior goals. RESULTS:: Participants were primarily male (99%), were white (77%), and had New York Heart Association III stage (52%). The mean (SD) age was 66 (11) years, and 71% reported 3 or more comorbidities. The intervention group compared with the usual care group showed a significant increase in activation/PAM scores from baseline to 6 months. No significant group-by-time interactions were found for the SCHFI scales. Although the baseline MOS Specific Adherence Scale mean was lower in the intervention group, results showed a significant group-by-time effect with the intervention group improving more over time. Participants in the intervention group had fewer hospitalizations compared with the usual care group when the baseline activation/PAM level was low or high. CONCLUSION:: This study supports the importance of targeted interventions to improve patient activation or engagement in HF care. Further work is needed related to HF self-management measurement and outcomes. |
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Authors:
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Martha J Shively; Nancy J Gardetto; Mary F Kodiath; Ann Kelly; Tom L Smith; Carl Stepnowsky; Charles Maynard; Carolyn B Larson |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-17 |
Journal Detail:
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Title: The Journal of cardiovascular nursing Volume: - ISSN: 1550-5049 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8703516 Medline TA: J Cardiovasc Nurs Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Martha J. Shively, PhD, RN Nurse Researcher, Nursing Service, VA San Diego Healthcare System, California. Nancy J. Gardetto, MSN, RNP-BC Nurse Practitioner/Clinical Manager Heart Failure Specialty Program, Nursing Service, VA San Diego Healthcare System, California. Mary F. Kodiath, MS, RNC, ANP Nurse Practitioner, Nursing Service, VA San Diego Healthcare System, California. Ann Kelly, MSN, PMHCNS-BC, RN Research Nurse, Nursing Service, VA San Diego Healthcare System, California. Tom L. Smith, PhD Principal Statistician, School of Medicine, Department of Psychiatry, University of California, San Diego. Carl Stepnowsky, PhD Psychologist, Medicine/Health Services, Research & Development, VA San Diego Healthcare System, California. Charles Maynard, PhD Research Scientist, Health Services Research, VA Puget Sound Healthcare System and University of Washington. Carolyn B. Larson, BSN, RN Registered Nurse, Nursing Service, VA San Diego Healthcare System, California. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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