Effect Of Motivational Interviewing On Self-care And Quality Of Life In Patients With Chronic Heart Failure

ObjectiveTo explore the status of the self-care and quality of life in patients with chronic heart failure(CHF),the effect of motivational interviewing(MI)on self-care and quality of life,and thereby explore effective intervention measures to improve the ability of patients’ self-care and quality of life.MethodsFrom February to June of 2016 years,110 patients with chronic heart failure(CHF)who were hospitalized in emergency cardiovascular department of a certain Grade 3-A comprehensive hospital in Shandong Province were selected by convenience sampling method,and randomly divided them into experimental group(n=55)and control group(n=55).Interventions of both usual care and motivational interviewing and telephone interview were used for the experimental group;usual care and telephone interview were used for the control group.Before intervention,following intervention and 3 months after intervention,self-care of heart failure index(SCHFI),Minnesota living with heart failure questionnaire(MLHFQ),re-hospitalization rate and mortality rate were used to evaluate the effect of intervention.A total of 94 patients completed the study,including 48 patients in the experimental group and 46 patients in the control group.The data were inputted and analyzed by SPSS 21.0 statistical software,measurement data was expressed as mean± standard deviation,enumeration data was indicated as a percentage,the general data of two groups,the re-hospitalization rate and mortality rate were compared with χ2 test,and the self-care behavior and quality of life were compared with a linear mixed model in different times.Results1.There was no significant difference between the experimental group and the control group in sociodemographic characteristics(such as age,gender,education level,payment method of medical expenses,family monthly income,etc.)and clinical characteristics(such as primary disease,number of complications,course of disease,annual hospital stay,duration of illness,body mass index,left ventricular ejection fraction,etc)on the baseline(P>0.05).2.Before intervention,the scores of each sub-scale of self-care in both groups were lower than 70,which indicated that the chronic heart failure patients’ self-care behavior was seriously inadequate.Before intervention,the scores for self-care maintenance scale,self-care management scale and self-care confidence scale were(35.52±12.95),(37.50±12.63),(17.72±13.26)in the experimental group,and the scores in the control group were(36.49±9.04),(37.28± 10.26),(19.10±11.88),there was no significant difference in the scores for each sub-scale of self-care between the two groups(P>0.05).After intervention,the scores for self-care maintenance scale,self-care management scale and self-care confidence scale were(52.73±6.35),(59.69±7.82),(59.77±7.12)in the experimental group,and the scores in the control group were(35.33±8.44),(41.96±6.79),(44.36±7.27).The scores of the experimental group were significantly higher than those of the control group(P<0.05).Three months after intervention,the scores for self-care maintenance scale,self-care management scale and self-care confidence scale were(53.72±6.76),(58.00±7.57),(50.53±7.39)in the experimental group,and the scores in the control group were(39.07±6.05),(46.71 ±6.67),(34.85±5.97).The scores for each sub-scale of self-care of patients in the experimental group were significantly higher than those in the control group(P<0.05).3.Before intervention,the scores for quality of life were higher in both groups.The total score for quality of life in the experimental group was(47.19± 12.30),the score for the somatic domain dimension was(20.31 ±5.22),the score for the emotional domain dimension was(10.06±3.85),the total score for quality of life in the control group was(47.33±8.79),the score for the somatic domain was(19.87±4.43),and the score for the emotional domain was(10.48±2.18).To compare the total score for quality of life and the scores for each dimension,there was no significant difference between the two groups(P>0.05).After intervention,the total score for quality of life in the experimental group was(35.46±3.11),the score for the somatic domain was(13.54±1.98),the score for the emotional domain was(9.42±1.32),the total score for quality of life in the control group was(42.24±3.19),the score for the somatic domain was(16.48±1.66)and the score for the emotional domain was(10.09±1.28).When the total score for quality of life and the score for somatic domain were compared,the scores of the experimental group were significantly lower than those of the control group in the same period(P<0.05).However,there was no significant difference between the two groups in the emotional domain(P>0.05).Three months after intervention,the total score for quality of life in the experimental group was(37.98±2.79),the score for somatic domain was(14.07±1.71),the score for emotional domain was(9.64±1.68),the total score for quality of life in the control group was(43.61±3.42),the score for somatic domain was(17.51± 1.31)and the score for emotional domain was(9.83±1.77).When the total score for quality of life and the score for somatic domain were compared,the scores of experimental group were significantly lower than those of control group(P<0.05).However,there was no significant difference in the scores for emotion domain(P>0.05).4.There was a significant difference in the rate of re-hospitalization between the experimental group and the control group(P<0.05).However,no significant difference in mortality rate was detected(P>0.05).Conclusions1.The self-care level of patients with chronic heart failure was low.Motivational interviewing intervention was capable to improve the self-care maintenance,self-care management and self-care confidence of patients with chronic heart failure,so as to improve the self-care ability of the patients.2.The status of quality of life in patients with chronic heart failure was poor,motivational interviewing intervention was capable to improve the quality of life in patients with chronic heart failure,especially in the somatic field.3.Motivational interviewing effectively reduced the rate of re-hospitalization in patients with chronic heart failure,and then reducing the economic burden of the society and families.