Effects of a Self-Management Program on Fluid Overload Prevention Behaviors and Clinical Outcomes in Newly Diagnosed Heart Failure Patients

Abstract

This two-group quasi-experimental research aimed to examine the effects of a self-management program on fluid overload prevention behaviors and clinical outcomes in newly diagnosed heart failure patients. The sample consisted of 48 patients with newly diagnosed heart failure who were admitted to the medical wards of Mahasarakham Hospital. Simple random sampling was performed separately for the control and experimental groups, with 24 participants recruited for each group. The control group received routine nursing care, whereas the experimental group received a self-management program combined with the use of the LINE application. The intervention period lasted 6 weeks. The research instruments included a fluid overload prevention questionnaire, a dyspnea assessment scale, a pitting edema assessment scale, and record forms for pulmonary congestion assessed by chest radiography and pulmonary auscultation for crepitant sounds. The reliability coefficients of these instruments were .95, .96, .90, and 1.00, respectively. Data were analyzed using frequencies, percentages, means, standard deviations, Chi-square test, Fisher’s exact test, Mann–Whitney U test, and Wilcoxon signed-rank test.

The results showed that, after the intervention, the experimental group had significantly higher overall fluid overload prevention behavior scores than the control group (p < .05). Furthermore, the experimental group demonstrated significantly lower dyspnea scores and pitting edema scores than the control group and significantly lower scores compared with their pre-intervention levels (p < .05).  In addition, the proportions of patients with pulmonary congestion assessed by chest radiography and pulmonary auscultation for crepitation sounds in the experimental group were significantly lower than those in the control group and significantly lower than before the intervention (p < .05). This study supports implementing the program for fluid overload prevention in patients with newly diagnosed heart failure.