Design of a Multiple-Behavior Change Intervention for Supporting Self-management in Patients With Chronic Heart Failure: An Intervention Mapping Approach.

IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Journal of Cardiovascular Nursing Pub Date : 2025-05-01 Epub Date: 2024-03-15 DOI:10.1097/JCN.0000000000001095
Joëlle Dam, Thijs M H Eijsvogels, Marjolein H I Verdijk, Anna M Janssen, Bram M A van Bakel, Lisette E H J M Baltussen, Gert P Westert, Marijn de Bruin
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Abstract

Background: Nonadherence to medication and low physical activity contribute to morbidity, mortality, and decreased quality of life among patients with chronic heart failure (CHF). Effective interventions that can be delivered during routine clinical care are lacking.

Objective: We aimed to adapt the feasible and cost-effective Adherence Improving self-Management Strategy (AIMS) for patients with human immunodeficiency virus (HIV) to CHF treatment. Subsequently, we determined its acceptability and feasibility.

Methods: Adherence Improving self-Management Strategy is a systematic, nurse-delivered counseling intervention blended with eHealth to facilitate patient self-management. We used the intervention mapping framework to systematically adapt AIMS-HIV to AIMS-CHF, while preserving essential intervention elements. Therefore, we systematically consulted the scientific literature, patients with CHF and nurses, and pretested intervention materials.

Results: Adherence Improving self-Management Strategy-HIV was modified to AIMS-CHF: a multiple-behavior change intervention, focused on medication adherence and physical activity. Key self-management determinants (such as attitudes, self-efficacy, and self-regulatory skills) and organization of care (such as specialized nurses delivering AIMS) were similar for HIV and heart failure care. The AIMS protocol, as well as material content and design, was systematically adapted to CHF. Preliminary testing suggests that AIMS-CHF is likely feasible and acceptable to patients with CHF and care providers.

Conclusion: Using the intervention mapping protocol, AIMS-HIV could be systematically adapted to AIMS-CHF and seems acceptable and feasible. Evidence from the literature, behavioral theory, and input from nurses and patients were essential in this process. Adherence Improving self-Management Strategy-CHF should now be tested for feasibility and effectiveness in routine care.

设计支持慢性心力衰竭患者自我管理的多重行为改变干预措施:干预映射法
背景:慢性心力衰竭(CHF)患者不坚持服药和体力活动少会导致发病率、死亡率和生活质量下降。目前尚缺乏可在常规临床护理过程中实施的有效干预措施:我们旨在将针对人类免疫缺陷病毒(HIV)感染者的 "坚持改善自我管理策略"(AIMS)应用于慢性心力衰竭的治疗中。随后,我们确定了其可接受性和可行性:坚持改善自我管理策略是一项由护士提供的系统性咨询干预措施,它与电子健康系统相结合,以促进患者的自我管理。我们利用干预映射框架将 AIMS-HIV 系统调整为 AIMS-CHF,同时保留了基本的干预要素。因此,我们系统地参考了科学文献、慢性阻塞性肺病患者和护士的意见,并对干预材料进行了预先测试:结果:"坚持改善自我管理策略-HIV "被修改为 "AIMS-CHF":一种多重行为改变干预,重点在于坚持用药和体育锻炼。艾滋病毒和心力衰竭护理的关键自我管理决定因素(如态度、自我效能和自我调节技能)和护理组织(如提供 AIMS 的专业护士)相似。AIMS 方案以及材料内容和设计已系统地适应于 CHF。初步测试表明,AIMS-CHF 很可能是可行的,并能为心力衰竭患者和护理提供者所接受:结论:使用干预映射协议,AIMS-HIV 可以系统地改编为 AIMS-CHF,并且似乎是可以接受和可行的。在这一过程中,文献证据、行为理论以及护士和患者的意见至关重要。坚持改善自我管理策略--CHF 现在应在常规护理中测试其可行性和有效性。
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来源期刊
CiteScore
3.30
自引率
10.00%
发文量
154
审稿时长
>12 weeks
期刊介绍: Official journal of the Preventive Cardiovascular Nurses Association, Journal of Cardiovascular Nursing is one of the leading journals for advanced practice nurses in cardiovascular care, providing thorough coverage of timely topics and information that is extremely practical for daily, on-the-job use. Each issue addresses the physiologic, psychologic, and social needs of cardiovascular patients and their families in a variety of environments. Regular columns include By the Bedside, Progress in Prevention, Pharmacology, Dysrhythmias, and Outcomes Research.
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