Theory-guided interventions for Chinese patients to adapt to heart failure: A quasi-experimental study

To examine the effects of the Roy Adaptation Model-based interventions on adaptation in persons with heart failure.

A quasi-experimental study was conducted in Hangzhou, China, from March 2018 to November 2019. A convenience sample of 112 participants with heart failure from a multi-campus hospital was enrolled. Participants were allocated into an intervention group (n = 55) and a control group (n = 57) according to their hospitalized campus. A culturally-tailored care plan intervention based on the Roy Adaptation Model was performed in the intervention group. The control group received bedside patient education and a regular booklet for HF home care before discharge. Heart ultrasound, Minnesota Living with Heart Failure Questionnaire (MLHFQ), a knowledge survey, Self-care Heart failure Index (SCHFI), and Coping and Adaptation Processing Scale-Short Form (CAPS-SF) were used to measure patients' levels of adaptation of physical function, self-concept, role function, and interdependence at baseline and six months after discharge.

Ninety-one participants with complete data, 43 in the intervention group and 48 in the control group, were included in the analysis for the primary endpoints and showed adaptive improvement trends. Most patients in the intervention group completed 60% or more of the given interventions. At the sixth month after discharge, compared with the control group, the intervention group had improved adaptive behaviors showing higher scores of the MLHFQ (70.90 ± 22.45 vs. 54.78 ± 18.04), heart failure-related knowledge (13.79 ± 2.45 vs. 10.73 ± 4.28), SCHFI maintenance (57.67 ± 13.22 vs. 50.35 ± 10.88), and CAPS-SF (40.23 ± 4.36 vs. 38.27 ± 2.60) at the six-month follow-up (P ＜ 0.05). There were no significant differences between the two groups in the scores of left ventricular ejection fraction, scores of SCHFI management and SCHFI confidence subscales (P > 0.05).

The findings reported evidence of positive adaptation in patients with heart failure, indicating that the Roy Adaptation Model is an effective guide for developing an implemented framework for the nursing practice of the patients. The culturally-tailored care plan intervention is helpful to improve adaptation of patients with heart failure.