A Single-Center, Randomized Controlled Trial to Test the Efficacy of Nurse-Led Motivational Interviewing for Enhancing Self-Care in Adults with Heart Failure

Author:

Dellafiore Federica1ORCID,Ghizzardi Greta2,Vellone Ercole23ORCID,Magon Arianna4ORCID,Conte Gianluca4ORCID,Baroni Irene4,De Angeli Giada4,Vangone Ida1,Russo Sara5ORCID,Stievano Alessandro67ORCID,Arrigoni Cristina1,Caruso Rosario48ORCID

Affiliation:

1. Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, 27100 Pavia, Italy

2. Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy

3. Department of Nursing and Obstetrics, Wroclaw Medical University, 50-368 Wrocław, Poland

4. Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy

5. Nursing Degree Course, Section Istituti Clinici di Pavia e Vigevano S.p.a., University of Pavia, 27100 Pavia, Italy

6. Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy

7. Centre of Excellence for Nursing Scholarship, OPI, 00136 Rome, Italy

8. Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy

Abstract

Background: The role of nurse-led motivational interviewing (MI) in improving self-care among patients with heart failure (HF) is promising, even if it still requires further empirical evidence to determine its efficacy. For this reason, this study tested its efficacy in enhancing self-care maintenance (primary endpoint), self-care management, and self-care confidence after three months from enrollment in adults with HF compared to usual care, and assessed changes in self-care over follow-up times (3, 6, 9, and 12 months). Methods: A single-center, randomized, controlled, parallel-group, superiority study with two experimental arms and a control group was performed. Allocation was in a 1:1:1 ratio between intervention groups and control. Results: MI was effective in improving self-care maintenance after three months when it was performed only for patients (arm 1) and for the patients–caregivers dyad (arm 2) (respectively, Cohen’s d = 0.92, p-value < 0.001; Cohen’s d = 0.68, p-value < 0.001). These effects were stable over the one-year follow-up. No effects were observed concerning self-care management, while MI moderately influenced self-care confidence. Conclusions: This study supported the adoption of nurse-led MI in the clinical management of adults with HF.

Funder

Italian Ministry of Health

Publisher

MDPI AG

Subject

Health Information Management,Health Informatics,Health Policy,Leadership and Management

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