Date of Award

3-2020

Document Type

DNP Project

College

School of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Jochebed Bea Ade-Oshifogun

Second Advisor

Jessica Gingerich

Abstract

Background

Heart failure is a complex disease and a growing global epidemic. Symptoms and multiple comorbidities contribute to the overwhelming burden of heart failure, and support people make an important contribution to self-care. Effective self-care maintenance behaviors along with confidence and support can help people living with heart failure to effectively self-manage the disease.

Purpose

This project aimed to determine if use of a mobile app with telephone support calls was an effective intervention to promote improved self-care of heart failure and caregiver contribution to self-care of heart failure compared to the standard of care where the intervention was not used.

Methods

This project used a quantitative quasi-experimental pretest-posttest design with a non-equivalent control group. Participants included people with heart failure and support people. The pretest and posttest were conducted to measure the effectiveness of a 90-day intervention compared to the standard of care. The evidence-based 90-day intervention, used a mobile app to track daily weight and heart failure symptoms with structured telephone support calls, aimed to improve self-care of and caregiver contribution to self-care of heart failure. This project was guided by the situation-specific theory of heart failure self-care.

Results

Thirty-five people completed the 90-day project period. While the small sample size and non-normally distributed variables likely contributed to a lack of significant results comparing the intervention to the standard of care, results within groups were interesting. Control group participants (n = 17) made no significant improvements from pretest to posttest in self-care maintenance, management, or confidence. However, intervention group participants (n = 18) made significant improvements from pretest to posttest in self-care management, t(10) = -2.031, p = 0.035, and confidence, t(17) = -3.766, p = 0.001. Examining the level of use of the app in intervention group households, participants in low-level use households (n = 10) made significant improvement from pretest to posttest in self-care confidence, z = -2.214, p = 0.018, while participants in high-level use households (n = 8) made significant improvements from pretest to posttest in self-care management, z = -1.826, p = 0.034, and confidence, z = -2.214, p = 0.014.

Conclusions

The intervention resulted in significantly improved self-care management and confidence for intervention group participants and improvement above adequate (70%) in self-care maintenance, management, and confidence for high-level users of the app. The results of this project validated the theory and the literature on evidence-based interventions to promote heart failure self-care. This intervention could be applied in practice as part of an individualized care plan to promote self-care of heart failure and caregiver contribution to self-care of heart failure.

DOI

https://dx.doi.org/10.32597/dnp/7/

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