This thesis describes the development and evaluation of a self-management intervention for people admitted to hospital with heart failure due to left ventricular systolic dysfunction. The intervention was delivered by a heart failure nurse specialist, following optimisation of in-patient medical treatment. It consisted of two sessions during the hospital stay, a home visit and follow-up telephone call. The content of the intervention and techniques for its delivery were detailed in a manual. The intervention was evaluated in a single-blind randomised controlled trial. The primary outcomes were the number of readmissions to hospital and duration of hospital stay in the 90 days after discharge from the index admission. Other outcomes included readmissions to hospital and duration of hospital stay in the 12 months after discharge, mortality, quality of life and psychological well-being. Process variables included self- management behaviours and cognitions. One hundred and sixty-five patients were recruited to the study and they were followed up for a period of 12 months. The intervention had a significant effect on aspects of self-management behaviour but did not demonstrate a significant effect on readmission to hospital or mortality in the total sample. However, a post-hoc sub-group analysis identified a significant impact of the intervention in those patients who were newly diagnosed with heart failure. Newly diagnosed patients in the intervention group had fewer admissions to hospital for heart failure and spent fewer days in hospital for heart failure during the 12 month follow-up period than those in the control group. The implications of the findings for future research and intervention development are discussed.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:634595 |
| Date | January 2008 |
| Creators | Mulligan, K. |
| Publisher | University College London (University of London) |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://discovery.ucl.ac.uk/1444519/ |
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