Implementation and Evaluation of Hospital-to-Home Transitional Care Intervention in Patients with Chronic Heart Failure

NCT06779227 | Completed DMC

• 1 other identifier: HUSOM2021-289
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This study lasted for a total of three months. The purpose is to build a hospital-family transitional nursing intervention program for patients with chronic heart failure, and to explore the effectiveness of the program on the self-management of patients with chronic heart failure, in order to provide certain empirical research for the clinical intervention of transitional nursing for patients with chronic heart failure. If you have any questions or difficulties, you can withdraw from this study at any time, which will not affect your treatment and nursing. The purpose of this study is to improve your self-care level and prevent your re-admission. It will not harm your physical and mental health and will not have a negative impact on the relationship between patients and nursing. You participate in this study and The personal data in the study is confidential, and any public report on the results of this study will not disclose your personal identity.

Conditions

Chronic Heart Failure

Outcome Measures

Primary Outcomes (1)

• Self-efficacy management indicators

  The measurement tool adopts the Chronic Disease Self-Efficacy Questionnaire compiled by Stanford University in the United States.The scoring consists of two dimensions: symptom management and disease-commonality management. The self-efficacy score for symptom management is calculated by averaging items 1, 2, 3, and 4 (if two or more items are missing or omitted, the variable is considered missing). A higher score indicates greater self-efficacy in symptom management. The self-efficacy score for disease-commonality management is obtained by averaging items 5 and 6. The score ranges from 1 to 5, a higher score indicates higher self-efficacy in disease-commonality management.

  Baseline, one month, three months

Secondary Outcomes (3)

• Self-care indicators

  Baseline, one month, three months

• Disease-related indicators

  Baseline, one month, three months

• Transitional nursing evaluation indicators

  Baseline, one month, three months

Other Outcomes (1)

• Re-hospitalisation indicators

  Baseline, one month, three months

Study Arms (2)

control group

NO INTERVENTION

The control group received routine care.

Intervention group

EXPERIMENTAL

The intervention group received a transitional care intervention mainly focused on the transitional care model (TCM).

Behavioral: Hospital family transitional nursing intervention

Interventions

Hospital family transitional nursing intervention BEHAVIORAL

The intervention group received a transitional care intervention mainly focused on the transitional care model (TCM).

Intervention group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• It meets the diagnostic criteria of the New York Heart Association (NYHA) for CHF, and the heart function level is II to III;
• Age ≥18 years old;
• The condition is stable and meets the standard of being discharged from the hospital;
• Clear consciousness, no communication barriers, able to understand and fill in the questionnaire correctly;
• Informed consent and voluntary participation in this study.

You may not qualify if:

• Patients with hepato-renal disfunction, sequelae of stroke, dementia;
• Patients with a history of mental disorders or already having mental disorders, critically ill patients.

Sponsors & Collaborators

• Zhi-fen Feng: lead

Study Sites (1)

Institute of Nursing and Health, School of Nursing and Health, Henan University

Kaifeng, Henan, 475004, China

Location

Related Publications (1)

• Feng ZF, Liu Y, Salvador JT, Ala MB, Nery MAC, Huang XY, Zhang L, Liu S. Implementation and evaluation of hospital-to-home transitional care intervention in patients with chronic heart failure. BMC Nurs. 2025 Jul 1;24(1):717. doi: 10.1186/s12912-025-03447-5.

  PMID: 40597265 DERIVED

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Associate Professor, School of Nursing and Health, Henan University

Study Record Dates

• First Submitted: December 30, 2024
• First Posted: January 16, 2025
• Study Start: October 15, 2021
• Primary Completion: June 20, 2022
• Study Completion: December 25, 2022
• Last Updated: January 16, 2025

Record last verified: 2024-12

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)