{"title":"The impact of a self-management program on volume overload among patients with heart failure in Thailand: A quasi-experimental study.","authors":"Napassawan Lungkawong, Rapin Polsook","doi":"10.33546/bnj.3730","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Volume overload is a common and serious complication in patients with heart failure, often leading to hospital readmissions and decreased quality of life. Effective self-management strategies are essential in preventing fluid accumulation and improving patient outcomes. Mobile technology offers a scalable means to support such interventions, particularly in culturally specific contexts.</p><p><strong>Objective: </strong>This study aimed to evaluate the effectiveness of a self-management program delivered via the LINE application in reducing volume overload among Thai patients with heart failure.</p><p><strong>Methods: </strong>A quasi-experimental design was employed with 46 participants randomly assigned to either a control or experimental group. The control group received standard care, while the experimental group participated in a four-week self-management program based on Lorig and Holman's theoretical framework, focusing on six key skills and three self-care tasks. Volume overload was assessed using a modified Framingham criteria-based instrument with confirmed content validity and acceptable reliability. Data were analyzed using paired and independent <i>t</i>-tests with IBM SPSS version 21.</p><p><strong>Results: </strong>Post-intervention, the experimental group showed a significant reduction in fluid volume overload scores (<i>M</i> = 6.96, <i>SD</i> = 1.46) compared to pre-intervention (<i>M</i> = 8.65, <i>SD</i> = 1.57, <i>t</i> = 9.90, <i>p</i> <0.001, Cohen's <i>d</i> = 1.11). The control group showed no significant change. An independent <i>t</i>-test confirmed a statistically significant difference between the experimental and control groups post-intervention (<i>t</i> = 3.67, <i>df</i> = 44, <i>p</i> <0.001, Cohen's <i>d</i> = 1.08), indicating a substantial effect of the intervention.</p><p><strong>Conclusion: </strong>The self-management program via the LINE application effectively reduced volume overload in Thai patients with heart failure. Integrating culturally familiar mobile technology and structured self-care education significantly enhanced patient engagement and health outcomes. This study highlights the importance of incorporating digital tools into patient education and follow-up for nursing practice to empower individuals in managing chronic conditions like heart failure. Future research should explore long-term impacts and scalability across diverse healthcare settings.</p><p><strong>Trial registry number: </strong>Thai Clinical Trials Registry (TCTR20241124001).</p>","PeriodicalId":42002,"journal":{"name":"Belitung Nursing Journal","volume":"11 3","pages":"349-356"},"PeriodicalIF":1.4000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107260/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Belitung Nursing Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.33546/bnj.3730","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"NURSING","Score":null,"Total":0}
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Abstract
Background: Volume overload is a common and serious complication in patients with heart failure, often leading to hospital readmissions and decreased quality of life. Effective self-management strategies are essential in preventing fluid accumulation and improving patient outcomes. Mobile technology offers a scalable means to support such interventions, particularly in culturally specific contexts.
Objective: This study aimed to evaluate the effectiveness of a self-management program delivered via the LINE application in reducing volume overload among Thai patients with heart failure.
Methods: A quasi-experimental design was employed with 46 participants randomly assigned to either a control or experimental group. The control group received standard care, while the experimental group participated in a four-week self-management program based on Lorig and Holman's theoretical framework, focusing on six key skills and three self-care tasks. Volume overload was assessed using a modified Framingham criteria-based instrument with confirmed content validity and acceptable reliability. Data were analyzed using paired and independent t-tests with IBM SPSS version 21.
Results: Post-intervention, the experimental group showed a significant reduction in fluid volume overload scores (M = 6.96, SD = 1.46) compared to pre-intervention (M = 8.65, SD = 1.57, t = 9.90, p <0.001, Cohen's d = 1.11). The control group showed no significant change. An independent t-test confirmed a statistically significant difference between the experimental and control groups post-intervention (t = 3.67, df = 44, p <0.001, Cohen's d = 1.08), indicating a substantial effect of the intervention.
Conclusion: The self-management program via the LINE application effectively reduced volume overload in Thai patients with heart failure. Integrating culturally familiar mobile technology and structured self-care education significantly enhanced patient engagement and health outcomes. This study highlights the importance of incorporating digital tools into patient education and follow-up for nursing practice to empower individuals in managing chronic conditions like heart failure. Future research should explore long-term impacts and scalability across diverse healthcare settings.
背景：容量过载是心力衰竭患者常见且严重的并发症，常导致再入院和生活质量下降。有效的自我管理策略对于预防积液和改善患者预后至关重要。移动技术提供了一种可扩展的手段来支持此类干预措施，特别是在特定文化背景下。目的：本研究旨在评估通过LINE应用程序提供的自我管理程序在减少泰国心力衰竭患者容量过载方面的有效性。方法：采用准实验设计，将46名受试者随机分为对照组和实验组。对照组接受标准护理，而实验组则参加为期四周的自我管理项目，该项目基于洛里格和霍尔曼的理论框架，重点关注6项关键技能和3项自我护理任务。体积过载评估采用改进的Framingham标准为基础的仪器，确认内容效度和可接受的信度。使用IBM SPSS version 21对数据进行配对和独立t检验。结果：干预后，实验组患者体液容量过载评分（M = 6.96, SD = 1.46）较干预前显著降低（M = 8.65, SD = 1.57, t = 9.90, p d = 1.11）。对照组无明显变化。经独立t检验，实验组与对照组干预后差异有统计学意义（t = 3.67, df = 44, p d = 1.08），干预效果显著。结论：通过LINE应用的自我管理程序有效地减少了泰国心力衰竭患者的容量过载。整合文化上熟悉的移动技术和结构化的自我保健教育显著提高了患者的参与度和健康结果。这项研究强调了将数字工具纳入患者教育和护理实践随访的重要性，以增强个人管理心力衰竭等慢性疾病的能力。未来的研究应该探索在不同医疗环境中的长期影响和可扩展性。试验注册号：泰国临床试验注册中心（TCTR20241124001）。
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