Display options
Cite
Howie-Esquivel J, Bibbins-Domingo K, Clark R, et al. A Culturally Appropriate Educational Intervention Can Improve Self-Care in Hispanic Patients With Heart Failure: A Pilot Randomized Controlled Trial. Cardiol Res. 2014;5(3):91-100doi: 10.14740/cr346w.
Howie-Esquivel, J., Bibbins-Domingo, K., Clark, R., Evangelista, L., & Dracup, K. (2014). A Culturally Appropriate Educational Intervention Can Improve Self-Care in Hispanic Patients With Heart Failure: A Pilot Randomized Controlled Trial. Cardiology research, 5(3), 91-100. https://doi.org/10.14740/cr346w
Howie-Esquivel, Jill, et al. "A Culturally Appropriate Educational Intervention Can Improve Self-Care in Hispanic Patients With Heart Failure: A Pilot Randomized Controlled Trial." Cardiology research vol. 5,3 (2014): 91-100. doi: https://doi.org/10.14740/cr346w
Howie-Esquivel J, Bibbins-Domingo K, Clark R, Evangelista L, Dracup K. A Culturally Appropriate Educational Intervention Can Improve Self-Care in Hispanic Patients With Heart Failure: A Pilot Randomized Controlled Trial. Cardiol Res. 2014 Aug;5(3):91-100. doi: 10.14740/cr346w. Epub 2014 Jul 20. PMID: 28348704; PMCID: PMC5358169.
Copy Download .nbib Format: NLM
Share it on

Cardiol Res. 2014 Aug;5(3):91-100. doi: 10.14740/cr346w. Epub 2014 Jul 20.

A Culturally Appropriate Educational Intervention Can Improve Self-Care in Hispanic Patients With Heart Failure: A Pilot Randomized Controlled Trial.

Cardiology research

Jill Howie-Esquivel, Kirsten Bibbins-Domingo, Robyn Clark, Lorraine Evangelista, Kathleen Dracup

Affiliations

  1. Department of Physiological Nursing, University of California, San Francisco, CA, USA.
  2. Department of Medicine, University of California, San Francisco General Hospital, San Francisco, CA, USA.
  3. School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia.
  4. Program in Nursing Science, University of California, Irvine, CA, USA.

PMID: 28348704 PMCID: PMC5358169 DOI: 10.14740/cr346w

Abstract

BACKGROUND: Hispanics constitute the largest US ethnic group and have been shown to have more frequent heart failure (HF) hospitalizations than non-Hispanic whites. Disease management programs can reduce HF hospitalizations and mortality by increasing patient self-care, but most programs are limited to patients who speak English. Therefore, we hypothesize that Project Fluido, a culturally appropriate self-care education intervention, will improve self-care behaviors and knowledge in Hispanic patients with HF compared with usual care (UC).

METHODS: Project Fluido (N = 42) was a randomized controlled pilot trial over 3 months. Patients in the experimental group (n = 22) received individualized education in Spanish using the "teach-back" method on the following: high salt foods, when to call the physician, when to report weight gain and the use of diuretics. They also received a nurse-initiated phone call every 2 weeks, a script for calling their physician with increased symptoms, a weight scale and a daily diary to complete. The UC group (n = 20) received a scale and written information. Self-care was measured using the self-care heart failure index and knowledge using teach-back scores. Four knowledge topics were included when using teach-back.

RESULTS: Participants' mean age was 57 ± 14 years, 57% (24) were male, 64% (27) had hypertension, 86% (36) were New York Heart Association Class I-III and 65% (26) had HF with reduced ejection fraction. Participant health literacy scores showed poor health literacy in 31% (n = 13) and 67% (n = 28) spoke Spanish only. Household income was reported as < $20,000 in 93% (n = 39). Self-care and knowledge scores significantly improved (P < 0.04 and P < 0.02, respectively) in the intervention group compared to UC.

CONCLUSION: The intervention utilized in Project Fluido was a remarkably effective method to improve self-care and HF knowledge in a group of Spanish-speaking HF patients. This improvement is in spite of low physical function, health literacy, acculturation and economic challenges. In addition, teach-back was an effective teaching strategy to improve HF knowledge. Future work is needed to investigate the relationship between increased self-care knowledge, readmissions, and mortality in Spanish-speaking patients with HF.

Keywords: Health literacy; Heart failure; Hispanic; Patient knowledge; Self-care

References

  1. J Cardiol. 2014 Dec;64(6):456-62 - PubMed
  2. J Cardiovasc Nurs. 2013 Mar-Apr;28(2):137-46 - PubMed
  3. Am J Prev Med. 2006 Mar;30(3):189-96 - PubMed
  4. J Gen Intern Med. 2001 Sep;16(9):606-13 - PubMed
  5. Res Nurs Health. 2013 Oct;36(5):500-11 - PubMed
  6. Arch Intern Med. 2003 Jan 13;163(1):83-90 - PubMed
  7. J Card Fail. 2006 Sep;12(7):554-67 - PubMed
  8. Heart Lung. 2000 Jan-Feb;29(1):4-15 - PubMed
  9. Issues Ment Health Nurs. 2012 Aug;33(8):522-7 - PubMed
  10. Am Heart J. 2005 Nov;150(5):983 - PubMed
  11. Med Care. 2008 Sep;46(9):924-9 - PubMed
  12. J Card Fail. 2006 Apr;12(3):211-9 - PubMed
  13. Circulation. 2014 Jan 21;129(3):e28-e292 - PubMed
  14. J Am Coll Cardiol. 2004 Aug 18;44(4):810-9 - PubMed
  15. J Natl Med Assoc. 2001 Dec;93(12 Suppl):18S-24S - PubMed
  16. PLoS Med. 2010 Mar 24;7(3):e1000251 - PubMed
  17. J Gen Intern Med. 2012 Oct;27(10):1317-25 - PubMed
  18. J Pediatr Nurs. 2012 Oct;27(5):451-9 - PubMed
  19. J Card Fail. 2006 Sep;12(7):584-5 - PubMed
  20. Am J Nurs. 2007 Dec;107(12):62-71; quiz 71-2 - PubMed
  21. Health Psychol. 2014 Jul;33(7):588-96 - PubMed
  22. J Pers Assess. 1990 Winter;55(3-4):610-7 - PubMed
  23. Circulation. 2014 Jan 21;129(3):399-410 - PubMed
  24. J Am Coll Cardiol. 2009 Apr 7;53(14):1167-75 - PubMed
  25. J Cardiovasc Nurs. 2010 Mar-Apr;25(2):117-23 - PubMed
  26. Health Serv Res. 2006 Aug;41(4 Pt 1):1392-412 - PubMed
  27. Med Care. 2004 Apr;42(4):313-20 - PubMed
  28. Circulation. 2014 Jul 15;130(3):256-64 - PubMed

Publication Types