Evaluation of a heart failure knowledge questionnaire and its use in guiding the educational intervention

J G Sánchez-Ramos; M D Lerma-Barba; D Segura-Rodríguez; A Pardo-Cabello; M T Molina-Ruiz; F Burillo-Gómez; S Martínez-Huertas; E Nieto-García; P Giner-Escobar; E Moreno-Escobar

doi:10.1016/j.rceng.2022.07.001

Evaluation of a heart failure knowledge questionnaire and its use in guiding the educational intervention

Rev Clin Esp (Barc). 2022 Nov;222(9):507-515. doi: 10.1016/j.rceng.2022.07.001. Epub 2022 Aug 8.

Authors

Affiliations

¹ Unidad de Insuficiencia Cardíaca, Servicio de Cardiología, Hospital Universitario Clínico San Cecilio, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain. Electronic address: jgsr525@gmail.com.
² Unidad de Insuficiencia Cardíaca, Servicio de Cardiología, Hospital Universitario Clínico San Cecilio, Granada, Spain.
³ Unidad de Insuficiencia Cardíaca, Servicio de Cardiología, Hospital Universitario Clínico San Cecilio, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
⁴ Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Unidad de Insuficiencia Cardíaca, Servicio de Medicina Interna, Hospital Universitario Clínico San Cecilio, Granada, Spain.
⁵ Servicio de Cardiología, Hospital Universitario Clínico San Cecilio, Granada, Spain.
⁶ Servicio de Cardiología, Hospital Universitario Clínico San Cecilio, Granada, Spain; Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Granada, Granada, Spain.
⁷ Servicio de Medicina Interna, Hospital Universitario Clínico San Cecilio, Granada, Spain.
⁸ Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Servicio de Cardiología, Hospital Universitario Clínico San Cecilio, Granada, Spain.

PMID: 35953419
DOI: 10.1016/j.rceng.2022.07.001

Abstract

Introduction and objective: Patient education by nurses is a cornerstone of any heart failure (HF) program, but the models are widely heterogeneous and few specific instruments exist. Our objective is to evaluate our own questionnaire and its utility as a guide for educational intervention.

Methods: This work is a prospective cohort study of patients followed-up on in a specialized unit after diagnosis of HF. The intervention group received educational sessions guided according to their knowledge using the questionnaire and was compared to a group which received standard education. The validity and reliability of the questionnaire was evaluated. The utility of the educational model was determined by the primary composite endpoint of death and/or hospital admission or emergency care for HF.

Results: A total of 152 patients were included, 88 which received guided education and 64 which received standard education, with a mean follow-up time of 16±4 months. In the guided education group, the evaluation questionnaire score (qs) rose from 59% to 78.5% (p=0.018), which was associated with greater self-care (28.5-0.6*qs, p=0.04), a tendency toward better quality of life (51.1-1.1*qs, p=0.09), and adherence (5.02+0.04*qs, p=0.06), with acceptable reliability (Cronbach's alpha 0.75). The primary composite endpoint was met in 12 patients (13.6%) in the intervention group compared to 19 (29.7%) in the control group (hazard ratio: 0.46; 95% confidence interval: 0.24-0.88; p=0.019). Only educational level, age, NT-proBNP, and atrial fibrillation were predictors in the multivariate analysis.

Conclusion: The HF knowledge questionnaire proposed is a valid, reliable tool and allows for quantifying learning. Its utility in guiding education requires a certain degree of skill from the patient that determines a group with better prognosis.

Keywords: Conocimiento; Cuestionario; Educación de pacientes; Heart failure; Heart failure clinic; Insuficiencia cardíaca; Knowledge; Outcomes; Patient education; Questionnaire; Resultados; Teach-back; Unidad de insuficiencia cardíaca.