Doctor of Philosophy (PhD)
First Advisor's Name
Jean Hannan, PhD, FAAN
First Advisor's Committee Title
Second Advisor's Name
Dorothy Brooten, PhD, FAAN
Second Advisor's Committee Title
Third Advisor's Name
JoAnne Youngblut, PhD, FAAN
Third Advisor's Committee Title
Fourth Advisor's Name
Timothy Page, PhD
Fourth Advisor's Committee Title
Heart failure, transitional care, patient perceptions, advanced practice nurse interventions, hospital readmission, posthospital discharge interventions, self-care, randomized controlled trial, telephone follow-up, heart failure costs
Date of Defense
Six and a half million Americans diagnosed with heart failure (HF) face dauntingly complex treatment regimens when transitioning from hospital to home care. Most are not prepared to perform their self-care. Advanced practice nurse (APN) interventions such as home visits as well as interventions that target perceived preparation for self-care have indicated improved health and costs outcomes. However, little is known about targeting perceived preparations for self-care with a low-cost APN intervention.
Purpose: This randomized controlled trial compared health outcomes, and healthcare charges between two groups of adults hospitalized with an HF diagnosis.
Methods: A control (n = 78) group received routine postdischarge care. An intervention group (n =76) received routine post discharge care plus follow-up telephone calls by APNs on posthospital discharge days 1, 7, 14, 21, 28, 42 and 56. Both groups were followed for the first 8 weeks posthospital discharge to examine health outcomes (i.e., perceived preparation for self-care, social support, problem-solving orientation), healthcare charges (i.e., emergency department visits, rehospitalizations) and charges for the APN follow-up (intervention group only).
Findings: At 8-weeks, comparing the intervention to the usual care group, the intervention group had significant differences in: perceived preparation for self-care mean scores (MI =67.37, SD = 16.6 vs. MC = 25.36, SD = 19, t(138) = -13.831, p=.000); hospital readmission rate (MI = 16.9% vs. Mc = 33.4%, χ2 = 4.59, p < .05); and mean healthcare charges (MI = $3,124, SD = $6,413 vs. MC = $6,897, SD = $11,268), t(142) = 2.45, p = .02)
Conclusion: Targeting a low-cost APN telephone follow-up intervention at subjective perceptions resulted in significantly higher levels of perceived preparation for self-care, lower rehospitalization rates and lower healthcare charges in the intervention group compared to the control group that did not receive APN interventions. These findings highlight the ability of APNs to apply low-cost, easy to apply follow-up interventions to vulnerable populations especially during times of major budget cuts that affect healthcare services.
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This work is licensed under a Creative Commons Attribution 4.0 License.
Reid, Valrie Evadne, "Heart Failure Patients' Perceptions of Preparation for Self-care" (2020). FIU Electronic Theses and Dissertations. 4571.
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