Introduction
Aim
Methods
Design
Inclusion and exclusion criteria
Literature search and study selection
Screening process and data extraction
Quality and certainty of the evidence assessment
Outcome
Data analysis
Results
Description of studies
Last Name of the first Author, year Country Study design | Setting of Recruitment Setting of intervention | Population | NYHA class Mean EF% at the baseline (SD/IQR 95%) | Intervention HCPs Delivering interventions | Control group/comparison | Sample size at baselines, dropout rate at follow-up | Outcome measures | Data collection instrument /tool (Reference of original tool) |
---|---|---|---|---|---|---|---|---|
Transitional care with face-to-face sessions, home visits, phone calls, or digital contact | ||||||||
Balk 2008 Netherlands RCT | Hospitals Hospital + TV channel + digital intervention | Patients with CHF in stable condition + NYHA class I-IV 66 years (33–87) | 7% of patients in NYHA class I, 40% of patients in NYHA class II, 48% of patients in NYHA class III, 2% of patients in NYHA class IV 31 (9–71) | Personalized plan (prescribed medication, advice about salt restriction, fluid intake, and lifestyle regimen) + MOTIVA system: band home TV-channel with educational material, health related surveys, motivational messages for lifestyle, reminders of medication. Intervention-plus: MOTIVAS + automated devices for daily measurements of blood pressure and weight + ranges were for blood pressure and weight + MSC staff available during office hours for phone contacts and analysis of the daily measurements Medical Service Center nurses trained in heart failure management | Managed by cardiologists and HF-nurses as standard local practice | 214; Follow-up from 2 to 537 days (mean 288 days) | Self-care behavior | European Heart Failure Self Care Behavior Scale (Jaarsma 2003) |
Chen 2018 China RCT | Hospital cardiology department Hospital + phone calls | Hospitalized patients with CHF aged 18–70 years 59.9 years (6.93) | 8% of patients in NYHA class I, 43.5% of patients in NYHA class II, and 48.5% of patients in NYHA class III NA | 4 MI sessions during hospitalization (15–20 min) to plan behavioural changes + telephone follow-up at 2, 4, 8 weeks (10–15 min) on behaviours on the health status, life, work, difficulties during changing behaviours; providing professional suggestions and reinforcing commitment to complete self-care plans. Investigator highly experienced in MI and cardiovascular nursing | 3–4 health education session by a nurse during hospitalization, telephone follow-up as intervention group | 72; 2 months: 13.9% | Self-care maintenance and management | Self-Care of Heart Failure Index (Riegel 2009) |
Cossette 2016 Canada RCT | Hospital Hospital + phone calls | HF patients who live with a primary caregiver with no cognitive problems and no planned regular specialized follow-up, dyads included 67 (NA) | 1 patient in NYHA class I, 13 patients in NYHA class II, 15 patients in NYHA class III, and 3 patients in NYHA class IV calculated: 30.62 (12.55) | 5 sessions: 2 of 30–45 min during hospitalization (1 with the dyad and 1 only with caregiver) + 3 phone calls (10 min) Intervention guide integrating Self-Determination Theory elements (perceived competence, autonomous motivation, and perceived relatedness). Role-playing involving the nurse and the caregiver during the encounters to provide practice in autonomy-supportive behaviors relating to patient self-care + educational checklist for nurses Project nurse | Usual discharge planning, bedside nurse providing information on HF, medication, nutrition. No telephone or hospital follow-up. | 32 patient-caregiver dyads; 1 month: 15.6% | Self-care maintenance | Self-Care of Heart Failure Index - (Riegel 2009) |
Davis 2012 USA RCT | Academic hospital Hospital + phone call | Patients hospitalized with exacerbation of heart failure and mild cognitive impairment 59 (13) | 2.4% of patients in NYHA class I, 45.6% of patients in NYHA class II, and 47.2% of patients in NYHA class III, 4.8% of patients in NYHA class IV 34 (19) | Self-care teaching (mean 44 min) based on cognitive training and environmental manipulation during hospitalization: workbook with pictograms for self-care schedule, personalized plan, problem-solving with scenario, audiotaping of teaching sessions, medication organizer and daily weight demonstration, self-monitoring diary, measuring cups + phone call at 24–72 h with teach back Nurse case manager | Standard discharge teaching for HF with HF booklet on symptom recognition and management, exercise, medication adherence, dietary and fluid restrictions, | 125; 1 month: 12.8% | Self-care-maintanance and management | Self-Care of Heart Failure Index (Riegel 2009) |
Evangelista 2015 USA Quasi-experimental study | Hospital Hospital + digital intervention + phone calls | Patients hospitalized with acute exacerbation of heart failure with no dementia or serious comorbidities 72.7 (8.9) | 69% patients in NYHA class II, and 30.9% in NYHA class III 26.5 (6.4) | Remote monitoring system platform, teaching to take weight, heart rate, and blood pressure daily for 3 months, step-by-step guide, number available 24/7. Phone call 24–48 h after discharge, teleconferencing, nurse- primary care provider collaboration to set limited advice, reset thresholds, provider outpatient visit, ER evaluation Research nurse | Primary care and specialty visits, home healthcare, post-hospital outpatient visits, 1 nurse phone call 1 day after discharge | 42; 3 months: 0% | Self-care maintenance and management | Self-Care of Heart Failure Index (Riegel 2009) |
Hoover 2017 USA Quasi-experimental study | Hospital Hospital + home + phone calls | Individuals ≥ 21 years able to read and understand English with no new diagnosis of HF and no significant cognitive impairment. 76.4 (range: 50–96) | 62% NYHA class III-IV NA | Coleman Care Transitions Intervention: Education/pharmacist medication reconciliation and teaching from nurses and pharmacist with patients and caregivers during hospitalization + 1 home visits within 72 h of discharge + 3 phone calls over the remaining 4 weeks focused on medication awareness and self-management, personal health record, appointments, signs and symptoms of exacerbations. Registered Nurse Transition Coach | Evidence-based HF education and medication reconciliation at the discharge + follow-up visit within 2 weeks by the provider or specialist. | 71; 1 month:7% | Self-care Maintenance and management | Self-Care of Heart Failure Index (Ref. NA) |
Hwang 2022 South Korea RCT | Hospital Hospital + phone calls | Patients hospitalized with heart failure with no cognitive impairment or serious comorbidity 66.2 years (13.58) | 9.8% patients NYHA class I, 19.7% in NYHA class II, 32% in NYHA class III, and 38.5% in NYHA class IV 40.30 (14.23) | 1 educational session during hospitalization (1 h) with written materials on HF signs & symptoms, treatment, diet and exercise recommendations and teach-back + 3 phone calls at 2, 4, and 8 weeks after discharge to manage barriers to self-care Principal Investigator - Nurse | Pre-discharge care to review medication and schedule follow-up appointment | 122; 3 months, 6 months: 18% | Self-care behaviors | 9-item European Heart Failure Self-Care Behavior Scale (Jaarsma 2009) |
Jaarsma 2000, Netherlands RCT | Hospital Hospital + phone call + home visit | Patients hospitalized with symptoms of chronic heart failure, over the age of 50, NYHA l class III and IV; heart failure diagnosis for longer than 3 months 74 years (9) | 17% of patients in NYHA class III, 22% in NYHA class III-IV, and 61% in NYHA class IV 34 (14) | Patient and family education in 4 sessions during hospitalization, a card on morning symptoms, a phone call within 3 days after discharge, and a home visit within 10 days after discharge for monitoring and teaching on disease and contacting a cardiologist, GP, or ER in case of problems. Education also includes HF self-care, medication adherence, support to access services, setting priorities, transports, etc. Educational materials on diet and fluid restrictions. Study nurses | Not structured patient education, a follow-up phone call, or a home visit from a nurse | 186; 1 month, 3 months, 9 months: 29% | Self-care abilities; Self-care behavior | Heart Failure Self-Care Behavior Scale |
Koberich 2015 Germany | Cardiology department of heart failure clinic Hospital + phone calls | Patients with LVEF </=40%, NYHA II - IV 61.7 years (12) | 66.4% of patients in NYHA class II, 29.1% of patients in NYHA class III, 4.5% of patients in NYHA class IV NA | 1 standardized education session on HF and HF self-care during hospitalization or at the clinic + 4 phone calls within three months (1, 4, 8 and 12 weeks after discharge or outpatient clinic appointment). Education on HF, medications, lifestyle, signs and symptoms and their management, traveling and recreational activities. Educational booklet on HF + diary for parameters. Nurse, principal investigator | Standard medical treatment | 128; 3 months: 14.6% | Self-care behaviors | 9-item European Heart Failure Self-care Behavior Scale (Jaarsma 2009) |
Leavitt 2020 USA RCT | Hospital Hospital + home visit | Patients with primary or secondary diagnosis of heart failure, over age 65, with no dementia 82.7 years (8.27) | NA 2 patients 15–19%, 5 patients 20–29%, 3 patients 30–39%, 5 patients 40–49%, 18 patients 50–59%, 6 patients 60–69%, 1 patient 70–79% | 1 visit during hospitalization providing a HF education booklet, HF teaching on pathophysiology, symptoms, and medications + 4 home visits over 30-days (1 within 72 h after discharge) for physical assessment, examining home environment, daily-life HF coping strategies CareNavRN nurse: RN interested in cardiology and at least 2 years of experience in home health | Printed and verbal HF discharge education delivered by primary hospital RN + home health care. No visits by the CareNavRN nurse. | 40; 1 month: 0% | Self-care Maintenance and management | Self-Care of Heart Failure Index (Riegel 2009) |
Moon 2018 Republic of Korea Quasi-experimental study | Hospital Hospital + phone calls | Patients with heart failure diagnosis of at least 6 months, LV EF < 50%, NYHA class II/III 13 (34.2%) patients aged 60–64, 7 (18.4%) age 65–69, 18 (47.4%) age 70–75 | NA 40.06 (6.57) | Education session on HF, the disease status, and self-management during hospitalization + educational booklet on HF, self-reported symptoms, self-care behaviours + phone calls (15–30 min) 1 time/week for 4 weeks on symptoms, problems with self-management, HF education on lifestyles, stress management Nurse | NA | 42; 5 weeks: 9.5% | Self-care behavior | 9-item European Heart Failure Self-care Behavior Scale (Jaarsma 2009) |
Sadeghi Akbari 2019 Iran RCT | Heart Center Hospital + phone calls | Patients with heart failure, an ejection fraction of less than 40, NYHA class II and III, no cognitive or psychiatric disorder or comorbidity calculated: 68.6 | NA < 40% (no mean reported) | Illness perception correction-based education (30 min per session) based on Leventhal self-regulation model over 3 days during hospitalization (30 min) on HF and control ability, written and verbal education on medications + an educational booklet + 8 weeks of phone calls (10 min) 1 time/week. Research nurse | Routine nursing care, including education on medications and advice to limit daily salt and water, weigh themselves daily and other advice related to their disease | 76; 2 months: 7.9% | Self-care behaviors | European Heart Failure Self-care Behavior Scale − 12 items |
Sun 2019 China RCT | Hospital Hospital + internet based medical platform + phone calls | Patients with CHF NYHA class > II IG: 68.21 (4.69) CG: 68.57 (4.12) | 35% patients in NYHA class II, 49% in class III, and 16% in class IV NA | Personalized health education plan with daily health education content on HF knowledge, treatment plan and goals, medication, exercise, nutrition, and prevention of acute attack over 3 days to help patients correct their self-care plan and monitored its implementation during hospitalization. After discharge: internet-based medical platform with a nurse available 9–17 daily + weekly health education program + self-care plan + messages sent with APP platform or WeChat public account + weekly phone calls for 3 months, 1 time/every 2 weeks after 3–4 months, 1 time/months after 5–6 months. Meeting of research team members every 2 months where patients or families were invited. Cardiology nurse, nursing staff | Nursing guidance at discharge with a health education manual + phone calls 2 weeks after discharge for monitoring and health guidance | 100; 3 and 6 months: 0% | Self-care maintenance and management | Self-Care of Heart Failure Index (Riegel 2009) |
Wonggom 2020 Australia RCT | HF outpatient clinic in hospital Hospital ward/HF clinic + m-health at home | Patients with a diagnosis of HF, NYHA class I to IV | 50% of patients in NYHA class I, 41.7% of patients in NYHA class II, 8.3% of patients in NYHA class III, 0% of patients in NYHA class IV 33.3% of patients with a LVEF < 40%, 30.6% of patients with a LVEF 40–49%, 36.1% of patients with a LVEF ≥ 50% | 1 session to teach how to use the app during hospitalization + avatar app on tablet on the topic: understanding HF, looking after yourself, things to do every day, emergency action plan. Research nurse | Bedside education, follow up at the HF clinic, booklet | 36; 1 month, 3 months: 2,8% | Self-care maintenance and management | Self-Care of Heart Failure Index (Riegel 2009) |
Yu 2015 China RCT | Hospital Hospital + home visit + phone calls | Patients with chronic health failure + >/= 60 years IG: 78.6 (7.1); CG: 78.7 (6.7) | 57.9% patients in NYHA class II, 39.3% in class III, and 2.8% in class IV IG:41.1 (16.1); CG: 39 (9.3) | Health counselling through pre-discharge visits, home visits on health status, self-care, concerns, beliefs + 2 weekly home visits focused on HF, psychological issues, educational on monitoring and management and self-care goals, find community support services + intensive telephone follow-up to monitor symptoms, give advice on self-care, counselling on the action plan, barriers to self-care + telephone access to cardiac nurse; Phone calls 1 week after the second home visit, then every 2 weeks for 3 months, and then every 2 months for 6 months. Cardiac nurse with a professional diploma in cardiovascular nursing and > 10 years of clinical experience in cardiac care | Teaching from pharmacy dispensers on hospital discharge, visits at the specialist clinic 4/6 weeks after discharge. | 178; 6 weeks: 12.9%, 3 months: 19.7%, 9 months:32.6% | Self-care maintenance and management | 18-item Chinese version of the Self-Care Heart Failure Index (modified version of Riegel 2004) |
Zamanzadeh 2013 Iran RCT | Hospital Hospital + phone calls | Patients diagnosed with NYHA class III or IV HF, had an LVEF < 40% 63.5 years (NA) | 48.7% in class III, and 51.3% in class IV IG:25.73 (9.2) CG: 24.05 (8.94) | HF education session (1 h) during hospitalization, individualized education booklet, phone calls (15 min) every two weeks for 3 months after discharge to check signs and symptoms and self-care behaviours. Education on signs and symptoms, medications, self-care behaviours, and lifestyles (i.e. diet). Based on Orem’s self-care theory. Nurse | Usual care provided by the hospital and physician visits | 80; 1 month, 2 months, 3 months: 2.5% | Self-care maintenance and management | Self-Care of Heart Failure Index (Riegel 2009) |
Home care with digital interventions or phone calls | ||||||||
De Souza 2014 Brazil RCT | Hospital Home + phone calls | Patients hospitalized for acute decompensated heart failure with LVEF < 45% 62 (13) | 6.3% of patients in NYHA class I, 37.6% of patients in NYHA class II, and 46% of patients in NYHA class III, 9.9% of patients in NYHA class IV 29.6 (8.9) | 4 home visits at 10–30 -60–120 days after discharge (60 min) for physical examination and education + phone calls (10 min). Education was on disease, self-care, medication adherence, side effects, signs and symptoms of exacerbation. Nurses | Outpatient visits with GP | 252; 6 months: 3.6% | Self-care | European heart failure self-care behavior scale (Jaarsma 2003) |
Clark 2015 USA RCT | Physician/advanced practice registered nurse (APRN) referrals, HF clinics, and media Home + phone calls/ e-mail | Non-hospitalized patients with chronic HF and NYHA class I to III; 45 years or older; living at home independently 62.4 (10.9) | 14% of patients in NYHA class I, 42% of patients in NYHA class II, 44% of patients in NYHA class III NA | Educational and skill-building program based on Stuifbergen’s health promotion focused on self-efficacy, Improving Your Memory booklet: 3 months of home visits every 10 to 14 days (1–1.5 h) for a total of 8 sessions on lifestyles, sign and symptoms, medications, stress, social and intimate relationships + 3 months of phone calls and/or e-mail (5–15 min) + 3-months no home visits, e-mails, or phone calls but only communicating with their physician if questions APRNs who were adult clinical nurse specialists with master’s or PhD education and expertise in HF and advanced cardiovascular nursing | Information on health promotion for adults/older adults with a notebook without HF information, scheduled meetings, no phone calls and e-mail | 50; 6 months: 0% | Self-care maintenance and management | 15-item Revised Selfcare of Heart Failure Index (Riegel 2004) |
Jiang 2021 Singapore 3-arm RCT | Hospital Home + digital intervention | Patients with HF using a smartphone everyday CG: 68.82 (13.14); IG A: 69.08 (10.51); IG B: 66.82 (11.81) | I-II (Mild to Moderate) NYHA class: CG: 30.4%; IG A 32.7%; IG B 28.1% NA | Usual care + group A and group B. Both group A and B received the HOM-HEMP intervention as HF self-management program adopting a psychosocial education approach with HF self-management toolkit + 3 home visits (40 min–1 h; 1 every 2 weeks). Educational materials on HF, salty foods, + drinking mugs with marks, scale, pill box with alarms + Educational plan + Motivational interviewing. Group B received a smartphone app with reminders for medication and appointments, weight/blood pressure/ symptom logs, educational information, chat room with nurse Research nurse trained in MI with 10 years of clinical experience | Medical, nursing, allied health and follow-up services at the hospital | 213 randomized/ 177 at the baseline; 3 months from baseline 4.5%, 6 months from baseline 8.5%, 6 months from randomization 23.9% | Self-care maintenance and management | Self-care of heart failure index (Riegel 2009) |
Hoban 2013 USA RCT | No profit home healthcare agencies Home + digital intervention | Patients a primary diagnosis of HF in the agency data enrolled in the HHA for home care services. 78.4 years (NA) | NA NA | Same as control group + telemonitoring equipment. Data were monitored by a telemonitor nurse coordinator daily or more frequently who contacted the patient, primary nurse, or physician when any changes in or missing data occurred. The telemonitor nurse coordinator and cardiac nursing team (experienced home healthcare registered nurses with a strong cardiac background) | Home visits 2–3 times/week, teaching on HF medications, low-sodium diet, fluid restrictions, daily weights, physical activity, HF booklet with symptoms listed and diary for weights | 80; 3 months: 25% | Self-care behavior | Self-Care of Heart Failure Index (Riegel 2004) |
Masterson Creber 2016 USA RCT | Hospital Home + phone calls | Patients hospitalized with primary or secondary diagnosis of heart failure, class NYHA II-IV, with no psychosis or cognitive impairment 62 (13.4) | 16.4% patients in NYHA class I/II, and 83.6% in class III/IV 36 (18.14) | Home-based MI to identify at least 2 personalized goals related to HF self-care, personalized plan reinforced with 3–4 phone calls over 90 days. Nurse | Patient education materials to help identify and address self-care barriers, maintain a lower sodium diet, active lifestyle targeting goal behavior changes through participant interaction | 100; 3 months:33% | Self-care Maintenance | Self-Care of Heart Failure Index (Riegel 2009) |
Motta 2013 Brazil RCT | Referral centers for HF patient treatment Home + phone calls | HF with ejection fraction of 45% or less, hospitalized due to decompensation of the disease n IG was 62.49 ± 13.65, against 63.37 ± 12.05 in CG | 6.5% of patients in NYHA class I, 41% of patients in NYHA class II, and 40.5% of patients in NYHA class III, 10.5% of patients in NYHA class IV IG: 29.3 ± 8; CG: 30.3 ± 9.5 | Home visits at 10th day, 1-2-3 months after discharge according to a protocol (Education on medication, weight control, salt and fluid restriction, physical exercise, annual vaccination, symptom recognition) + 4 phone calls 15 to 30 days after the visits Nurses specialized in HF patient care | Usual care with outpatient visits or not | 200; 6 months: 24.5% | Self-care; Treatment adherence | European Heart Failure Self Care Behavior Scale − 12 Items; |
Shao 2013 Taiwan RCT | Cardiac clinics Home + Phone calls | patients with HF + >/=65 years + NYHA I - III + discharged from cardiology wards 72.04 (5.48) | 7.4% patients in NYHA class I, 65.7% in class II, 26.9% in class III < 20%: 7.4% of patients; 21–40%: 70.4% of patients; >40%: 26.9%of patients | Self-management program focused on self-efficacy (Bandura 1997). The program consisted of 5 sessions of self-management program (1 home visit within 3 days after enrolment, 4 phone calls at 1, 3, 7, 11 weeks), diary of daily sodium and fluid intake, daily weight. Education on HF, self-monitoring and self-management. Action plan to monitor low salt diet, fluid and weight. Nurse | Phone calls at 3, 7, 11 weeks after discharge from the research assistant using the ‘Telephone guide-control group’, different from the intervention group. | 108; 1 month and 3 months: 13.9% | Self-management | European Heart Failure Self-care Behavior Scale (Jaarsma 2003) - modified version: Heart failure Self-management behavior scale − 10 items |
Remote care with digital interventions or phone calls | ||||||||
Brandon 2009 USA RCT | HF DRG list provided by the cardiologist Phone calls | Adults with HF IG: 60 years (49–69); CG NA | 25% of patients in NYHA class I, 50% of patients in NYHA class II, 20% of patients in NYHA class III, 5% of patients in NYHA class IV NA | 7 calls delivered as 1 call/week for 2 weeks, then every 2 weeks for 10 weeks; education on HF, low sodium diet, calling physician with symptoms of exacerbation, smoking cessation, flu/pneumonia vaccinations, medication adherence Advanced practice nurse | Education from physician/RN on exercise, low sodium intake, medication, calling physician with symptoms of exacerbation, variable frequency of clinic visits | 20; 3 months: 0% | Self-care behavior | Revised Self-care behaviors scale (Artinian 2002) |
Shearer 2007 USA RCT | Hospital Phone calls | Patients with HF over 21 years of age 76.03 (8.32) | 41.9% patients in NYHA class II, 47.7% in class III, 8.1% in class IV; 2.3% NA IG: 36% (14.86); CG: 33% (15.76) | Same as control group + telephone-delivered empowerment intervention with phone calls 1 to 3 days after discharge, then at 2, 4, 6, 8, 12 weeks on valued goals, HF signs and symptoms, adherence to an action plan on self-care, self-management, and functional health. Base on Rogers’ Science of Unitary Human Beings person-environment process to foster empowerment. Calls were conducted according to a standardized script. Nurse clinicians experienced in HF care | Nursing standardized HF education plan on HF signs and symptoms and plan care adherence to a prescribed plan of care during hospitalization | 71; 3 months:8.4% | Self-management | Self-Management of Heart Failure (SMHF) scale |
Ware 2022 Canada RCT | Heart Function Clinic in hospital Digital intervention | Patients with diagnosed with HF with reduced ejection fraction (< 40%), uncontrolled HT (≥ 140/90 mm Hg auscultatory), or insulin-requiring DM and performing self-capillary glucose monitoring 59 (12.6) for overall sample not only those with HF | NA NA | Smartphone + Bluetooth devices (weight scale, blood pressure monitor, and blood glucose monitor); instruction to monitor their daily weight, blood pressure, heart rate, and symptoms, and Medly smartphone app. The app was for (a) telemonitoring to record physiological measurements with wireless home medical devices, (b) receiving automated answer symptom questions and self-care instructions based on algorithms (the app send alerts to the clinical team via email). Historical trends were viewable on a secure web portal. None or nurse practitioner | Clinical visits every 3 to 6 months, optimization of medical therapy, self-management education | 66; 6 months: NA for HF | Self-care maintenance and management | Self-Care of Heart Failure Index (Riegel 2009) |
Vuorinen 2014 Finland RCT | Cardiology Outpatient Clinic of Helsinki University Central Hospital Digital intervention | Patients with heart failure, with age of 18–90 years, NYHA class ≥ 2, LVEF ≤ 35%, need for a regular check-up visit, and time from the last visit of less than 6 months CG:57.9 (11.9); IG:58.3 (11.6) | 38.3% of patients in NYHA class II, 58.8% of patients in NYHA class III, 3.2% of patients in NYHA class IV CG:28.6 (5.0); IG:27.3 (4.9) | Home-care package with a weight scale, a blood pressure meter, a mobile phone, and self-care instructions; measurements with the assessment of symptoms 1 time/week; automatic feedback if parameter was within personal targets set by the nurse; the nurse checked the data 1 time/week or more frequently when measurement was beyond target levels or different from the previous one. Nurse of the cardiac team | Multidisciplinary care approach, guidance and support for self-care, patients’ visits to the clinic and by phone calls | 94; 6 months: 1.1% | Self-care | European Heart Failure Self-Care Behavior Scale (Jaarsma 2003) |
Intervention components | Outcomes | |||||||||||||||||
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Hospital sessions | Home visits | Structured phone calls follow-up | Motivational interviewing | Reminders for medications | Motivational messages | Digital tool | Telemonitoring | Action plan/goal settingon self-care | Education on self-monitoring | Education on lifestyle (diet, PA etc.) | Education on HF, signs and symptoms | Education on medication adherence | Educational materials | Other information on the intervention | Self- management | Self-care maintenance | Self-care behaviors | |
Home care | ||||||||||||||||||
Hoban et al., 2013 | ● | ● | ● | ● | ● | ● | ● | + (NR) | ||||||||||
Clark et al., 2015 | ● | ● | ● | Stuifbergen’s health Promotion + social and stress support | 0.03 | 0.06 | ||||||||||||
Masterson Creber et al., 2016 | ● | ● | ● | ● | ● | ● | 0.08 | |||||||||||
Jiang et al., 2021 | ● | ● | ● | ● | ● | ● | ● | Pill box with alarms | 0.001 | 0.001 | ||||||||
Shao et al., 2013 | ● | ● | ● | ● | ● | + (NR) | ||||||||||||
De Souza et all; 2014 | ● | ● | ● | ● | ● | Self-efficacy (Bandura) | MA | |||||||||||
Motta et al., 2013 | ● | ● | ● | ● | ● | ● | MA | |||||||||||
Transitional care | ||||||||||||||||||
Balk et al., 2008 | ● | ● | ● | ● | ● | ● | TV channel | ± (NR) | ||||||||||
Hwang et al., 2022 | ● | ● | ● | ● | ● | ● | Teach back | < 0.001 | ||||||||||
Jaarsma et al., 2000b | ● | ● | ● | ● | ● | ● | ● | ● | 0.11 | |||||||||
Moon et al., 2018 | ● | ● | ● | ● | ● | ● | ● | Stress management | < 0.001 | |||||||||
Sadeghi Akbari et al., 2019 | ● | ● | ● | ● | ● | Leventhal self-regulation model | < 0.001 | |||||||||||
Koberich et al., 2015 | ● | ● | ● | ● | ● | ● | ● | 0.043 | ||||||||||
Hoover et al., 2017 | ● | ● | ● | ● | ● | ● | ● | Coleman Care Transitions Intervention + medication reconciliation | 0.08 | 0.47 | ||||||||
Zamanzadeh et al., 2013 | ● | ● | ● | ● | ● | ● | ● | Orem’s self-care theory | < 0.001 | < 0.001 | ||||||||
Yu et al., 2015 | ● | ● | ● | ● | ● | ● | ● | Providing community support services | > 0.05 | < 0.05 | ||||||||
Cossette et al., 2016 | ● | ● | ● | Self-Determination Theory | MA | |||||||||||||
Chen et al., 2018 | ● | ● | ● | ● | ● | ● | ● | MA | MA | |||||||||
Leavitt et al., 2020 | ● | ● | ● | ● | ● | ● | Home environment examination | MA | MA | |||||||||
Davis et al., 2012 | ● | ● | ● | ● | ● | ● | Cognitive training + environmental manipulation + teach-back | MA | MA | |||||||||
Evangelista et al., 2015 | ● | ● | ● | ● | MA | MA | ||||||||||||
Wonggom et al., 2020 | ● | ● | ● | ● | ● | MA | MA | |||||||||||
Sun et al., 2019 | ● | ● | ● | ● | ● | ● | ● | MA | MA | |||||||||
Remote care | ||||||||||||||||||
Brandon et al., 2009 | ● | ● | ● | ● | 0.001 | |||||||||||||
Shearer et al., 2007 | ● | ● | ● | ● | Rogers’ Science of Unitary Human Beings process | + (NR) | ||||||||||||
Vuorinen et al., 2014 | ● | ● | ● | 0.298 | ||||||||||||||
Ware et al., 2022 | ● | ● | ● | Automatic self-care instructions | 0.40 | 0.82 |
Risk of bias
Effects of interventions
Self-care maintenance
Certainty assessment | № of patients | Effect | Certainty | |||||||
---|---|---|---|---|---|---|---|---|---|---|
№ of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Nursing intervertions delivered totally or partially at home | usual care | Absolute (95% CI) | |
Self-care Maintenance | ||||||||||
7 | randomised trials | seriousa | not serious | not serious | seriousb | none | 205 | 211 | MD 7.26 higher (5.2 higher to 9.33 higher) | ⨁⨁◯◯ Low |
Self-care Management | ||||||||||
6 | randomised trials | seriousa | not serious | not serious | seriousc | none | 194 | 198 | MD 5.02 higher (1.34 higher to 8.69 higher) | ⨁⨁◯◯ Low |
Self-care behaviours | ||||||||||
2 | randomised trials | not serious | not serious | seriousd | not serious | none | 193 | 201 | MD 7.91 lower (9.29 lower to 6.54 lower) | ⨁⨁⨁◯ Moderate |