The impact of sense of coherence on quality of life and self-care ability after an interactive patient education programme for patients with heart failure

Main Article Content

Patrik Lynga
Mårten Rosenqvist
Ann Langius-Eklöf

Abstract

Rationale, aims and objectives: Patient education is most commonly implemented in the follow-up of heart failure patients to enhance self-care ability. Results sometimes differ between studies and it is suggested that the patients’ personal characteristics should be considered when evaluating patient education. The aim was to explore whether a person’s degree of sense of coherence (SOC) was related to quality of life (QoL) and self-care ability as outcomes of an interactive patient education programme.Methods: A descriptive design was used and an interactive patient education programme was implemented as a complement to routine care. The 13-item SOC Scale, the Quality of Life Index Questionnaire (QLI) and the European Heart Failure Self-care Behaviour Scale (EHFScBS) were used as measurements. Fifty-seven patients participated at baseline, 3- and 12 month follow-up.Results: There were no significant correlations (p = 0.45-0.66) between the degree of SOC and scores on the EHFScBS. The degree of SOC correlated significantly (r = 0.36-0.46, p = 0.001-0.006) with the QLI scores indicating that the higher the SOC, the higher the QoL. The SOC and QLI scores remained stable (p = 0.94 and 0.25-0.89 respectively) throughout the study period. The only self-care item that improved significantly was adherence to medication.Conclusions: The patients’ degree of SOC did not influence the outcomes but might be useful as to identify heart failure patients at risk of perceiving low QoL. The interactive patient education programme did not improve the patient’s total self-care ability or quality of life.

Article Details

Section
Regular Articles

References

. Stewart, S., Macintyre, K., Hole, D, J., Capewell, S. & McMurray, J, J, V. (2001). More malignant than cancer? Five-year survival following a first admission for heart failure. European Journal of Heart Failure 3, 315-322.

. Hobbs, F. D., Kenkre, J. E., Roalfe, A. K., Davies, R. C., Hare, R. & Davies, M, K. (2002). Impact of heart failure and left ventricular systolic dysfunction on quality of life: A cross-sectional study comparing common chronic cardiac and medical disorders and a representative adult population. European Heart Journal 23, 1867-1876.

. Dickstein, K., Cohen-Solal, A., Filiippatos, G., et al. (2008). ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008. European Journal of Heart Failure 10, 933-989.

. Juenger, J., Schellberg, D., Kraemer S., Haunstetter, A., Zugck, C., Herzog, W. & Haass, M. (2002). Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart 87, 235-241.

. Grady, K, L. (2008). Self-care and Quality of Life Outcomes in Heart Failure Patients. Journal of Cardiovascular Nursing 23, 285-292.

. Strömberg, A., Dahlström, U. & Fridlund, B. (2006). Computer-based education for patients with chronic heart failure. A randomised, controlled, multicentre trial of the effects on knowledge, compliance and quality of life. Patient Education and Counseling 64, 128-135.

. Johansson, P., Dahlström, U. & Broström, A. (2006). Factors and interventions influencing health-related quality of life in patients with heart failure: A review of the literature. European Journal of Cardiovascular Nursing 5, 5-15.

. Calman, K, C. (1984). Quality of life in cancer patients – an hypothesis. Journal of Medical Ethics 10, 124-127.

. Antonovsky, A. (1987). Unraveling The Mystery of Health - How People Manage Stress and Stay Well. San Francisco, CA: Jossey-Bass publishers.

. Nesbitt, B, J. & Heidrich, S, M. (2000). Sense of Coherence and Illness Appraisal in Older Women´s Quality of Life. Research in Nursing and Health 23, 25-34.

. Cohen, M. & Kanter,Y. (2004). Relations between sense of coherence and glycemic control in type 1 and type 2 diabetes. Behavioral Medicine 29, 175-183.

. Ferrans, C, E. & Powers, M, J. (1992). Psychometric assessment of the Quality of Life Index. Research in Nursing and Health 15, 29-38.

. Jaarsma, T., Strömberg, A., Mårtensson, J. & Dracup, K. (2003). Development and testing of the European Heart Failure Self-care Behaviour Scale. European Journal of Heart Failure 5, 363-370.

. Langius, A. & Björvell, H. (1996). Salutogenic model and utilization of the KASAM form (Sense of Coherence) in nursing research – a methodological report. Vård i Norden 16, 28-32.

. Eriksson, M. & Lindström, B. (2005). Validity of Antonovsky`s sense of coherence scale: a systematic review. Journal of Epidemiology and Community Health 59, 460-466.

. Gullberg, M, T., Hollman-Frisman, G. & Ek, A-C. (2010). Reference values for the Quality of Life index in the general Swedish population 18-80 years of age. Quality of Life Research 19, 751-760.

. Lupon, J., González, B., Mas, D., Urrutia, A., Arenas, M., Domingo, M., Altimir, S. & Valle, V. (2008). Patients’ self-care improvement with nurse education intervention in Spain assessed by the European heart failure self-care behaviour scale. European Journal of Cardiovascular Nursing 7, 16-20.

. Peters-Klimm, F., Campbell, S., Hermann, K., Kunz, C, U., Muller-Tasch, T. & Scecsenyi, J. (2010). Case management for patients with chronic systolic heart failure in primary care: The HICMan exploratory randomized controlled trial. Trials 11, 56.

. Scott, L, D., Setter-Kline, K. & Britton, A. (2004). The Effect of Nursing Interventions To Enhance Mental Health and Quality of Life Among Individuals With Heart failure. Applied Nursing Research 17, 248-256.

. Hagell, P. & Westergren, A. (2006). The significance of importance: An evaluation of Ferrans and Powers quality of life index. Quality of Life Research 15, 867-876.