The Effect of a Telephone-Based Self-management Program Led by Nurses on Self-care Behavior, Biological Index for Cardiac Function, and Depression in Ambulatory Heart Failure Patients

PURPOSE: This study was conducted to examine the effects of a telephone-based self-management support program led by nurses on self-care behavior, biological index for cardiac function, and depression. METHODS: This study is a quasi-experiment in nonequivalent control group design. Thirty-eight heart failure patients underwent medical treatment at the hospital (18 heart failure patients in the experimental group and 20 heart failure patients in the control group). The experimental group (n = 18) received the telephone-based self-management support program, which included a 30-minute face-to-face education session and four telephone consultation and education sessions. The face-to-face education session was conducted at the first visit to the outpatient clinic. Thereafter, weekly telephone consultations and education sessions were performed for 4 weeks. Data were analyzed using descriptive statistics, Chi-square test, Fisher's exact test, independent t test, paired t test, and repeated measures analysis of variance using the SPSS/WIN 21.0. RESULTS: The participants in the experimental group showed significantly increased self-care behavior scores (t = 6.65, p < .001), decreased N-terminal pro-brain natriuretic peptide level (U= −2.28, p = .022), improved left ventricular ejection fraction values (t = 2.24, p = .032), and decreased depression scores (t = −3.49, p = .001) compared with the control group. CONCLUSION: The findings indicate that the telephone-based self-management program is an effective intervention to improve self-management in heart failure patients.

Comparison of Walking, Muscle Strength, Balance, and Fear of Falling Between Repeated Fall Group, One-time Fall Group, and Nonfall Group of the Elderly Receiving Home Care Service

PURPOSE: The purpose of this study was to provide information to develop a program to prevent repeated falls by analyzing the difference in gait, muscle strength, balance, and fear of falling according to their fall experience. METHODS: The study subjects were 110 elderly individuals aged over 60 years who agreed to their participation in this research. The study participants were categorized into a repeated fall group (n = 40), a one-time fall group (n = 15), and a nonfall group (n = 46) of the elderly. Measurements of gait, muscle strength, balance, and fear of falling were taken in each group. RESULTS: With regard to gait, there were significant differences among three groups in gait cycle (F = 3.50, p = .034), speed (F = 13.06, p < .001), and cadence (F = 5.59, p = .005). Regarding muscle strength in the upper and lower limbs, statistically significant differences were shown among three groups in muscle strength of upper (F = 16.98, p < .001) and lower (F = 10.55, p < .001) limbs. With regard to balance, the nonfall group had significantly greater results than the one-time fall group and repeated fall group in dynamic balance (F = 10.80, p < .001) and static balance (F = 8.20, p = .001). In the case of the fear of falling, the repeated fall group had significantly higher score than other two groups (F = 20.62, p < .001). CONCLUSION: This study suggests that intervention program should be tailored to fall risk factors to enhance gait and balance and lower body muscle strength and reduce the fear of falling to prevent repeated incidences of falls in this population.