Educational level and self-care behaviour in patients with heart failure before and after nurse educational intervention

Beatriz González, Josep Lupón, Maria Del Mar Domingo, Lucía Cano, Roser Cabanes, Marta De Antonio, Miquel Arenas, Eva Crespo, Margarita Rodríguez, Antoni Bayes-Genis

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22 Citations (Scopus)


© The European Society of Cardiology 2013. Background: Self-care is important for heart failure (HF) management and may be influenced by the patient's educational level.Aim: We assessed the relationship of educational level with baseline self-care behaviour and changes one year after a nursing intervention in HF outpatients attending a HF unit.Patients and method: Three hundred and thirty-five HF patients were studied, with a median age of 67 years (P25-75 57-75) and a median HF duration of six months (P25-75 1-36). HF aetiology was mainly ischaemic heart disease (53.4%). Median ejection fraction was 30% (P25-75 24-37%). The functional class was mainly II (66.3%) and III (25.7%). Educational levels were: very low 17.3%; low 62.1%; medium-high 20.6%. Patients were evaluated at the first visit (baseline) and one year after the educational intervention with the nine-item European Heart Failure Self-care Behaviour Scale.Results: Median patient scores differed in the baseline (19 (P25-75 15-26) vs. 16 (P25-75 13-21) vs. 15 (P25-75 12.5-15.5)) and the one-year evaluation (15 (P25-75 13-17) vs. 13 (P25-75 11-15) vs. 12 (P25-75 10-14)) for the three educational levels, respectively, with statistically significant differences between levels (p=0.007 to p < 0.001) except between low and medium-high education at one year (p=0.057). In the one-year evaluation, self-care behaviour significantly improved in the three educational groups (p<0.001), with a similar, albeit not statistically significant, magnitude of improvement in all groups.Conclusions: Self-care behaviour at baseline and one year after a nursing intervention was better in patients with a higher education, although the improvement with the intervention was similar irrespective of the educational level.
Original languageEnglish
Pages (from-to)459-465
JournalEuropean Journal of Cardiovascular Nursing
Issue number5
Publication statusPublished - 1 Jan 2014


  • Heart failure
  • literacy
  • self-care behaviour


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