![]() Boyde et al.’s (2018) randomized controlled trial showed that self-care educational intervention using TBM for HF patients effectively reduced unplanned hospital readmission by 30 %. Several studies have identified the effectiveness of TBM for discharge education, finding that it increased knowledge retention, improved self-care, and reduced the readmission rate for HF patients. The TBM is defined as a communication confirmation method used by HCPs to confirm whether a patient or caregiver understands what is being explained to them. These findings indicate that effective discharge education is needed to improve self-management among HF patients.Įducational interventions using the teach-back method (TBM) for chronically ill patients who have difficulties in self-management have improved knowledge, adherence, self-efficacy, self-care skills, and readmission rates. In addition, HF patients adhered to their prescribed medication regimes but did not follow the recommended behavioral changes, including physical activity and weight monitoring. A previous study reported that fewer than 10 % of all patients who received discharge education understood what they had learned. Some studies have suggested that the low efficacy of self-management interventions was caused by the knowledge gap between health care professionals (HCPs) and patients. However, a meta-analysis result from 5,264 HF patients showed that self-management interventions were ineffective in reducing readmission rate. Effective self-management interventions for HF patients could theoretically improve their health outcomes, including readmission, short-term mortality, and quality of life. Care for HF patients includes complex medication adherence, symptom management, weight management, dietary management, and physical activity. ![]() It is generally known that HF is a common disease in elderly patients, and that HF patients have difficulties in self-management because of the complexity of the disease characteristics. In other words, either hospitals did not allow hospitalization of severe HF patients, or high-quality care services are required to enhance self-care in the community and at home after discharge. After the HRRP was implemented, the readmission rate of HF patients in the US decreased slightly, but their short-term mortality rate increased. The Korean government has also used readmission rate as a hospital quality indicator since 2016. The US started the hospital readmission reduction program (HRRP), which reduces the payment to hospitals with excess readmissions, in 2012 and chose HF as a target disease. In Korea, the prevalence of HF has been increasing steadily since 2002, and the readmission rate of HF patients (27.6 %) is as high as in developed countries. The 30-day readmission rates for HF in developed regions, such as the United States (US) and Europe, are greater than 20 %. Recently, governments and policymakers have begun to pay attention to the readmission rate of HF patients to reduce unnecessary health care costs. The global burden of HF has been increasing, with 26 million patients suffering from HF globally. Heart failure (HF) is a complex clinical syndrome resulting from structural and functional heart problems, such as impairment of ejection fraction in ventricles and a low level of tissue or organ perfusion. The process we used to develop this program could guide researchers and clinical practice. We expect the discharge education program using TBM to enhance self-management among HF patients. ![]() The contents and methods of the program were appropriate for patients and providers. The understandability and actionability were 90.2 and 91.3 % in patients, and 94.6 and 86.8 % in nurses. The overall CVI for the program was 0.96, and all item CVIs were greater than 0.8. The discharge education program provides definitions and information about medication, symptom/weight/diet management, physical activity, and other precautions. The content validity index (CVI), and understandability and actionability of the educational material were used. MethodsĪs a methodological study to develop a program, we applied the analysis, design, development, implementation, and evaluation (ADDIE) model comprised of (1) analysis using EMR data, systematic review, and focus group interviews, (2) design and development of a program draft, (3) tests of program validity using 15 experts, 10 nurses, and 10 patients, and (4) development of the final program. This study aimed to develop a discharge education program for HF patients using the teach-back method (TBM). Heart failure (HF) patients have difficulties in self-management after discharge.
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