The effects of a self-regulation programme on self-care behaviour in patients with heart failure: A randomized controlled trial

Background: Self-care behaviour is important for patients with heart failure to prevent disease progression. More than half of patients have poor self-care behaviour. Self-regulation theory emphasizes that patients need to initiate monitoring of their symptoms, identify their own problems, and perform appropriate self-care behaviour. However, studies focused on interventions based on self-regulation theory for patients with heart failure are limited.

Objectives: To investigate the effects of a self-regulation programme on self-care behaviour in patients with heart failure.

Design: A randomized controlled trial.

Participants and setting: Eighty-two patients with heart failure were recruited from a cardiovascular outpatient department at a teaching hospital in northern Taiwan.

Methods: Participants were randomly assigned to the intervention (n = 41) or control group (n = 41). The intervention group participated in a 4-week self-regulation programme, including one 20-to-30-min, face-to-face individual self-regulation education session and 15- to 20-min telephone follow-up counselling sessions twice per week for four weeks. The control group received only routine outpatient care. Self-care behaviour was measured by the Self-Care of Heart Failure Index at baseline, 4 weeks and 8 weeks after patients were enroled.

Results: The intervention group reported improvements in self-care behaviours, including self-maintenance and self-confidence subscale scores, after four weeks of the self-regulation programme. In contrast, the control group showed no significant differences. Compared with the control group, the intervention group exhibited significantly greater improvements in self-care maintenance (B = 3.74, p = 0.01), self-care management (B = 6.33, p = 0.004), and self-care confidence (B = 5.15, p = 0.003) at four weeks but showed significantly greater improvements only in self-care management (B = 6.97, p = 0.03) and self-care confidence (B = 6.24, p = 0.001) at 8 weeks.

Conclusions: This study confirmed that a self-regulation programme could effectively improve self-care behaviour in patients with heart failure. Further studies with multicentre randomized controlled trials and larger populations of heart failure patients are necessary to evaluate the effect of this self-regulation programme in various regions and countries. Tweetable abstract: A home-based self-regulation programme could effectively improve self-care behaviour in patients with heart failure.