The online version of this article (doi:10.1186/1471-2261-14-173) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
NS, JC, CSF and DRT were involved in the conception and design of study and drafting of the manuscript. All authors read and approved the final manuscript.
Heart failure (HF) significantly impacts on the daily lives of patients and their carers. In Western society HF education programs have increased patient and carer knowledge and improved health-related quality of life. However, there is a paucity of such evidence in Asia. For example, to date no studies have been conducted in Thailand to investigate the potential benefits of a family-based education program on the health outcomes of HF patients and carers.
This randomised controlled trial will evaluate the effectiveness of an education program on knowledge, self-care and health-related quality of life of Thai HF patients and their carers. Assessments will be conducted at baseline, three and six months. Participants will be assigned by independent random allocation to an intervention (family-based education plus usual care) or a control (usual care) group. Analyses will be conducted on an intention-to-treat basis.
This trial will be the first to evaluate the effectiveness of family-based education for HF patients and carers residing in rural Thailand. It attempts to advance understanding of family-based HF education and address the gap in service provision.
Thai Clinical Trial Registry TCTR20140506003
Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Judd SE, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Mackey RH, Magid DJ, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, American Heart Association Statistics Committee and Stroke Statistics Subcommittee, et al: Heart disease and stroke statistics-2014 update: a report from the American Heart Association. Circulation. 2014, 129 (3): e28-e292. 10.1161/01.cir.0000441139.02102.80. CrossRefPubMed
Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, Ikonomidis JS, Khavjou O, Konstam MA, Maddox TM, Nichol G, Pham M, Piña IL, Trogdon JG: Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail. 2013, 6 (3): 606-619. 10.1161/HHF.0b013e318291329a. CrossRefPubMedPubMedCentral
Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, Fonarow GC, Gerac SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL: 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2013, 62 (16): e147-e239. 10.1016/j.jacc.2013.05.019. CrossRefPubMed
McAlister FA, Stewart S, Ferrua S, McMurray JJJV: Multidisciplinary strategies for the management of heart failure patients at high risk for admission: a systematic review of randomized trials. J Am Coll Cardiol. 2004, 44 (4): 810-819. PubMed
Blue L, Lang E, McMurray JJV, Davie AP, McDonagh TA, Murdoch DR, Petrie MC, Connolly E, Norrie J, Round CE, Ford I, Morrison CE: Randomised controlled trial of specialist nurse intervention in heart failure. Br Med J. 2001, 323 (7315): 715-718. 10.1136/bmj.323.7315.715. CrossRef
Strömberg A, Mårtensson J, Fridlund B, Levin L-A, Karlsson J-E, Dahlstråm U: Nurse-led heart failure clinics improve survival and self-care behaviour in patients with heart failure results from a prospective, randomised trial. Eur Heart J. 2003, 24 (11): 1014-1023. 10.1016/S0195-668X(03)00112-X. CrossRefPubMed
Rich MW, Beckham V, Wittenberg C, Leven CL, Freedland KE: A multidisciplinary interventertion to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med. 1995, 2 (333): 1190-1195. CrossRef
Laothavorn P, Hengrussamee K, Kanjanavanit R, Moleerergpoom W, Laorakpongse D, Pachirat O, Boonyaratavej S, Sritara P: Thai Acute Decompensated Heart Failure Registry (Thai ADHERE). CVD Prev Control. 2010, 5 (3): 89-95. 10.1016/j.cvdpc.2010.06.001. CrossRef
Ditewig JB, Blok H, Havers J, Veenendaal HV: Effectiveness of self-management interventions on mortality, hospital readmissions, chronic heart failure hospitalization rate and quality of life in patients with chronic heart failure: a systematic review. Patient Educ Couns. 2010, 78 (3): 297-315. 10.1016/j.pec.2010.01.016. CrossRefPubMed
Rankin SH, Stallings KD: Patient Education: Principles & Practice. 2001, Philadelphia, PA: Lippincott, Williams and Wilkins, 4
Moser DK, Riegel B: Improving Outcomes in Heart Failure: An Interdisciplinary Approach. 2001, Gaithersburg, MD: Aspen
Delaney C, Apostolidis B, Bartos S, Heather M, Smith L, Fortinsky R: A randomized trial of telemonitoring and self-care education in heart failure patients following home care discharge. Home Health Care Manag Pract. 2013, 25 (5): 187-195. 10.1177/1084822312475137. CrossRef
Krum H, Jelinek MV, Stewart S, Sindone A, Atherton JJ, Hawkes AL: Guidelines for the prevention, detection and management of people with chronic heart failure in Australia 2006. Med J Aust. 2006, 185 (10): 549-556. PubMed
McMurray JJV, Adamopoulos S, Anker SD, Auricchio A, Bo¨hm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Gomez-Sanchez MA, Jaarsma T, Køber L, Lip GY, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Rønnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher A: ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Eur Heart J. 2012, 33 (14): 1787-1847. CrossRefPubMed
Barnason S, Zimmerman L, Young L: An integrative review of interventions promoting self-care of patients with heart failure. J Clin Nurs. 2011, 21 (3–4): 448-475. PubMed
Riegel B, Moser DK, Anker SD, Appel LJ, Dunbar SB, Grady KL, Gurvitz MZ, Havranek EP, Lee CS, Lindenfeld J, Peterson PN, Pressler SJ, Schocken DD, Whellan DJ: State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation. 2009, 120 (12): 1141-1163. 10.1161/CIRCULATIONAHA.109.192628. CrossRefPubMed
Buck HG, Harkness K, Wion R, Carroll SL, Cosman T, Kaasalainen S, Kryworuchko J, McGillion M, O’Keefe-McCarthy S, Sherifali D, Strachan PH, Arthur HM: Caregivers’ contributions to heart failure self-care: a systematic review. Eur J Cardiovasc Nurs. in press
Årestedt K, Saveman B-I, Johansson P, Blomqvist K: Social support and its association with health-related quality of life among older patients with chronic heart failure. Eur J Cardiovasc Nurs. 2013, 12 (1): 69-77. PubMed
Arnold JMO, Howlett JG, Ducharme A, Ezekowitz JA, Gardner MJ, Giannetti N, Haddad H, Heckman GA, Isaac D, Jong P, Liu P, Mann E, McKelvie RS, Moe GW, Svendsen AM, Tsuyuki RT, O’Halloran K, Ross HJ, Sequeira EJ, White M: Canadian Cardiovascular Society Consensus Conference guidelines on heart failure – 2008 update: best practices for the transition of care of heart failure patients, and the recognition, investigation and treatment of cardiomyopathies. Can J Cardiol. 2008, 24 (1): 21-40. 10.1016/S0828-282X(08)70545-2. CrossRefPubMedPubMedCentral
Krum H, Jelinek MV, Stewart S, Sindone A, Atherton JJ, National Heart Foundation of Australia; Cardiac Society of Australia and New Zealand: 2011 update to National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand guidelines for the prevention, detection and management of chronic heart failure in Australia 2006. MJA. 2011, 194 (8): 405-409. PubMed
Kiatseesakul J, Momkong S, Pankakdee O, Choon-Ngarm T: The effect of a supportive educational program on knowledge self-care behavior, and the level of severity of heart failure. Thai J Cardio-Thoracic Nurs. 2008, 19 (2): 23-39.
Rerkluenrit J, Khwanchai P, Soiorn T: Effects of a supportive educational program on functional status and self-care of persons with heart failure. Rama Nurs J. 2012, 18 (1): 102-118.
Knodel J, Chayovan N: Intergenerational relationships and family care and support for Thai elderly. Ageing Int. 2009, 35 (1–4): 15-27.
McKelvie RS, Moe GW, Ezekowitz JA, Heckman GA, Costigan J, Ducharme A, Estrella-Holder E, Giannetti N, Grzeslo A, Harkness K, Howlett JG, Kouz S, Leblanc K, Mann E, Nigam A, O’Meara E, Rajda M, Steinhart B, Swiggum E, Le VV, Zieroth S, Arnold JM, Ashton T, D’Astous M, Dorian P, Haddad H, Isaac DL, Leblanc MH, Liu P, Rao V, et al: The 2012 Canadian Cardiovascular Society heart failure management guidelines update: focus on acute and chronic heart failure. Can J Cardiol. 2013, 29 (2): 168-181. 10.1016/j.cjca.2012.10.007. CrossRefPubMed
Knowles MS, Holton EF, Swanson RA: The Adult Learner: The Definitive Classic in Adult Education and Human Resource Development. 2005, London: Elsevier
Yu M, Chair SY, Chan CE, Li X, Choi KC: Perceived learning needs of patients with heart failure in China: a cross-sectional questionnaire survey. Contemp Nurse. 2012, 41 (1): 41-47. 10.5172/conu.2012.41.1.41. CrossRef
Borrelli B, Sepinwall D, Ernst D, Bellg AJ, Czajkowski S, Breger R, DeFrancesco C, Levesque C, Sharp DL, Ogedegbe G, Resnick B, Orwig D: A new tool to assess treatment fidelity and evaluation of treatment fidelity across 10 years of health behavior research. J Consult Clin Psychol. 2005, 73 (5): 852-860. CrossRefPubMed
Kripalani S, Bengtzen R, Henderson LE, Jacobson TA: Clinical research in low-literacy populations: using teachback to assess comprehension of informed consent and privacy information. IRB Ethics Human Res. 2008, 30 (2): 13-19.
Chew LD, Griffin JM, Partin MR, Noorbaloochi S, Grill JP, Snyder A, Bradley KA, Nugent SM, Baines AD, VanRyn M: Validation of screening questions for limited health literacy in a large VA outpatient population. J Gen Intern Med. 2008, 23 (5): 561-566. 10.1007/s11606-008-0520-5. CrossRefPubMedPubMedCentral
The Criteria Committee of the New York Heart Association: Diseases of the Heart and Blood Vessels: Nomenclature and Criteria for Diagnosis. 1994, Boston, MA: Little; Brown, 9
Boyde M, Song S, Peters R, Turner C, Thompson DR, Stewart S: Pilot testing of a self-care education intervention for patients with heart failure. Eur J Cardiovasc Nurs. 2012, 12 (1): 39-46. PubMed
Boyne JJ, Vrijhoef HJ, Spreeuwenberg M, Weerd GD, Kragten J, Gorgels AP, TEHAF investigators: Effects of tailored telemonitoring on heart failure patients’ knowledge, self-care, self-efficacy and adherence: a randomized controlled trial. Eur J Cardiovasc Nurs. 2014, 13 (3): 243-252. 10.1177/1474515113487464. CrossRefPubMed
Chiaranai C, Salyer J: Self-care and quality of life in patients with heart failure: do gender differences exist?. Songkla Med J. 2009, 27 (6): 451-463.
World Health Organisation: Process of translation and adaptation of instruments. [ http://www.who.int/substance_abuse/research_tools/translation/en/]
- Trial of a family-based education program for heart failure patients in rural Thailand
Chantal F Ski
David R Thompson
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