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Article: The Effects of the Technology-Based Family-Centered Empowerment (T-FamE) Heart Failure Transitional Program: Preliminary Analysis of a Randomized Controlled Trial

TitleThe Effects of the Technology-Based Family-Centered Empowerment (T-FamE) Heart Failure Transitional Program: Preliminary Analysis of a Randomized Controlled Trial
Authors
Issue Date6-Nov-2023
PublisherLippincott, Williams & Wilkins
Citation
Circulation, 2023, v. 148 (Suppl 1), p. A16949 How to Cite?
Abstract

Introduction: Health digitization and advanced dyadic science offer new opportunities to enhance the transitional care model for heart failure (HF). The T-FamE program a transitional care model integrating digital health and optimized carer support to enhance the post-discharge outcomes of HF patients.

Hypothesis:The T-FamE was more effective than usual care to enhance self-care, perceived control, family function, HRQoL and hospital readmission of HF patients.

Methods: From Aug 2021 to March 2022, a RCT randomized 170 post-discharge HF patients (mean age = 69.0; SD=11.5; NYHA Grade II/III/IV = 53.9/40.6/.5.5%. LVEF<40% =58.5%) to the T-FamE or usual care. The 12-week nurse-delivered T-FamE comprises an interactive mobile Apps, which allows i) proactive health monitoring with tailored autonomous guideline-based feedback; ii) family-centerd goal-setting on self-care, iii) personalized drug education, iv) mobile access to nurse, v) video-based HF compass for rehabilitation and self-care. The cardiac nurse conducted three monthly visits for family-based empowerment on disease management. Outcome evaluation by Self-care Heart Failure index, Self-care Self-Efficacy Scale, Control Attitude Scale, Family Functioning Device and EuroQoL at baseline and post-test.

Results: Two-way analysis of covariance showed significant greater improvement of T-FamE group on self-care maintenance (F=21.46, p<0.001, η2p=0.113), management (F=22.52, p=0.01, η2p=0.118), symptom perception (F=69.70, p<0.001, η2p=0.29) and confidence (F=13.36, p<0.001, η2p=0.073) than the control. They have greater improvement in EuroQoL (F=5.78, p=0.017, η2p=0.033) and sense of control (F=5.78, p=0.017, η2p=0.033), and significantly lower number ore readmission in one year (-0.278 (95%CI=-0.54, -0.008, p=0.043).

Conclusions: The T-FamE is effective to improve the self-care, HRQL and readmission outcomes. Digitalized transitional care model with optimized family support play explain the therapeutic benefits. Autonomous response to health monitoring data may enhance self-care decision-making.


Persistent Identifierhttp://hdl.handle.net/10722/340026
ISSN
2023 Impact Factor: 35.5
2023 SCImago Journal Rankings: 8.415

 

DC FieldValueLanguage
dc.contributor.authorYu, Doris S-
dc.contributor.authorLi, Polly WC-
dc.contributor.authorWong, CW-
dc.contributor.authorCheng, V-
dc.date.accessioned2024-03-11T10:41:06Z-
dc.date.available2024-03-11T10:41:06Z-
dc.date.issued2023-11-06-
dc.identifier.citationCirculation, 2023, v. 148 (Suppl 1), p. A16949-
dc.identifier.issn0009-7322-
dc.identifier.urihttp://hdl.handle.net/10722/340026-
dc.description.abstract<p><strong>Introduction:</strong> Health digitization and advanced dyadic science offer new opportunities to enhance the transitional care model for heart failure (HF). The T-FamE program a transitional care model integrating digital health and optimized carer support to enhance the post-discharge outcomes of HF patients.</p><p><strong>Hypothesis:</strong>The T-FamE was more effective than usual care to enhance self-care, perceived control, family function, HRQoL and hospital readmission of HF patients.</p><p><strong>Methods:</strong> From Aug 2021 to March 2022, a RCT randomized 170 post-discharge HF patients (mean age = 69.0; SD=11.5; NYHA Grade II/III/IV = 53.9/40.6/.5.5%. LVEF<40% =58.5%) to the T-FamE or usual care. The 12-week nurse-delivered T-FamE comprises an interactive mobile Apps, which allows i) proactive health monitoring with tailored autonomous guideline-based feedback; ii) family-centerd goal-setting on self-care, iii) personalized drug education, iv) mobile access to nurse, v) video-based HF compass for rehabilitation and self-care. The cardiac nurse conducted three monthly visits for family-based empowerment on disease management. Outcome evaluation by Self-care Heart Failure index, Self-care Self-Efficacy Scale, Control Attitude Scale, Family Functioning Device and EuroQoL at baseline and post-test.</p><p><strong>Results:</strong> Two-way analysis of covariance showed significant greater improvement of T-FamE group on self-care maintenance (F=21.46, p<0.001, η<sup>2</sup><sub>p</sub>=0.113), management (F=22.52, p=0.01, η<sup>2</sup><sub>p</sub>=0.118), symptom perception (F=69.70, p<0.001, η<sup>2</sup><sub>p</sub>=0.29) and confidence (F=13.36, p<0.001, η<sup>2</sup><sub>p</sub>=0.073) than the control. They have greater improvement in EuroQoL (F=5.78, p=0.017, η<sup>2</sup><sub>p</sub>=0.033) and sense of control (F=5.78, p=0.017, η<sup>2</sup><sub>p</sub>=0.033), and significantly lower number ore readmission in one year (-0.278 (95%CI=-0.54, -0.008, p=0.043).</p><p><strong>Conclusions:</strong> The T-FamE is effective to improve the self-care, HRQL and readmission outcomes. Digitalized transitional care model with optimized family support play explain the therapeutic benefits. Autonomous response to health monitoring data may enhance self-care decision-making.</p>-
dc.languageeng-
dc.publisherLippincott, Williams & Wilkins-
dc.relation.ispartofCirculation-
dc.titleThe Effects of the Technology-Based Family-Centered Empowerment (T-FamE) Heart Failure Transitional Program: Preliminary Analysis of a Randomized Controlled Trial-
dc.typeArticle-
dc.identifier.doi10.1161/circ.148.suppl_1.16949-
dc.identifier.volume148 (Suppl 1)-
dc.identifier.spageA16949-
dc.identifier.eissn1524-4539-
dc.identifier.issnl0009-7322-

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