Animation-Based Nutrition Education Improves Nutrition Behavior, Symptoms, and Quality of Life in Heart Failure

This study evaluated the effect of animation video-based nutrition education on nutritional behaviors, symptom burden, and quality of life in patients with heart failure. A repeated-measures randomized controlled trial was conducted with an intervention group (n = 33) and a control group (n = 30). The intervention group received animation video-based nutrition education, while the control group received standard procedure. Data were collected at baseline and at 1-, 3-, and 6-month follow-ups. Statistical analyses included descriptive statistics, repeated-measures analysis of variance, and Minimal Clinically Important Difference (MCID) calculations. In addition, mediation analysis using Hayes' PROCESS macro was conducted to examine the mechanistic pathways among nutritional behaviors, symptom burden, and quality of life. The significance of indirect effects was tested using bootstrap resampling with 5,000 iterations. The intervention group demonstrated significant improvements in nutritional behavior, reductions in symptom burden, and enhanced quality of life. Time-by-group interactions favored the intervention group significantly. Notably, the magnitude of changes exceeded established MCID thresholds, confirming clinical significance. Serial mediation analysis showed that the effect of the intervention on quality of life was fully indirect and was transmitted through improvements in nutritional behavior; the hypothesized sequential pathway involving symptom burden was not supported. Animation video-based nutrition education represents an effective intervention for heart failure patients, demonstrating both statistical and clinical significance. Digital-based educational modalities yield superior outcomes compared with traditional approaches.