Effects of discharge education using teach-back methods in patients with heart failure: A randomized controlled trial

Background: Heart failure is one of the most common causes of hospital readmission. Self-care is an essential but challenging task for patients with heart failure, and inadequate self-care is closely related to unplanned readmis-sion and unnecessary health expenditure. Patient-centered education using the teach-back method emerged as a key strategy to prevent patients' adverse events by improving self-care.Objective: To evaluate the effects of discharge education using the teach-back method on self-care, self-care efficacy, symptoms of heart failure, caregiver dependency, and unplanned healthcare resource utilization among patients with heart failure. Design: A prospective, two-arm randomized controlled trial. Setting(s): Four adult cardiology units at a tertiary hospital in Seoul, South Korea. Participants: A total of 100 patients diagnosed with heart failure and scheduled to be discharged to their homes.Methods: The intervention group received the HEART program (R) in addition to the usual discharge education by a trained nurse before discharge, while the control group received usual discharge education only. The discharge ed-ucation included the definition of heart failure, medication, symptom management, diet, physical activity, and other precautions. Data on self-care (self-care maintenance; symptom-perception; self-care management), self-care effi-cacy, symptoms of heart failure, and caregiver dependency were measured at 7-days after discharge (T1), and un-planned healthcare resource utilization (including readmission, emergency room visit, and healthcare professional contacts) was assessed at 1-month after discharge (T2). Outcomes were analyzed with ANCOVA. Results: A total of 94 patients (intervention group = 45, control group = 49) completed outcome measurements at the three-time points. Participants in the intervention group showed a significant improvement in self-care maintenance (F = 11.597, p = 0.001), symptom perception (F = 20.173, p < 0.001), self-care management (F = 7.205, p = 0.009), and self-care efficacy (F = 4.210, p = 0.043) compared to the control group. However, there were no statistically significant differences in symptoms of heart failure, caregiver dependency, and unplanned healthcare resource utilization between the two groups (all ps > 0.05).Conclusions: The findings demonstrated that discharge education using the teach-back method is an effective educational strategy to improve self-care and self-care efficacy in patients with heart failure. We recommend nurses implement discharge education using the teach-back method for patients with heart failure. Registration: This study was registered at the Clinical Research Information Service (KCT0004444) on November 15, 2019, and the participant recruitment was initiated in June 2020.(c) 2023 Elsevier Ltd. All rights reserved.