supporting health in veterans with heart failure

Conditions: Heart Failure

Summary: this study will test the effectiveness of a culturally-sensitive, telephone-based, tailored problem-solving intervention to improve physical and mental health in veterans with heart failure (hf). veterans will be recruited from va clinics throughout the united states. as a component of this study, veterans will partner with a registered nurse for a 12-week telehealth program that includes 8 telephone sessions. follow-up data will be collected at 3-months (post intervention) and 6-, 12-, and 18-months to examine sustainability of intervention effect.

the long-term goal of this research is to support physical and mental health of veterans with heart failure and enrich rehabilitation and independent living by enhancing disease self-management and coping processes in the home. study objectives include: (1) evaluate the feasibility of recruitment and enrollment processes, attrition, and program acceptability in a sample of veterans with hf; (2) evaluate program effectiveness on study outcomes (i.e., self-care, symptoms, depression, anxiety, quality of life, stress, resilience, coping, and healthcare utilization); and (3) examine the sustainability of intervention effect. this study will be guided by quantitative inquiry and include a single-group, repeated measures design. a sample size of 100 participants is desired based on a power analysis for repeated measures anova with 5 time points, alpha level of .05, a medium effect size (f = 0.25), and 80% power, plus oversampling for potential attrition (20%). following verbal informed consent via telephone, all participants will complete baseline data collection which will include a sociodemographic and clinical survey, the interpersonal support evaluation list - 12 (isel), the social problem-solving inventory revised-short (spsirs), the self-care of heart failure index (schfi, v 7.2), the heart failure symptom survey (hfss), the patient health questionnaire-9 (phq-9), the generalized anxiety disorder (gad) scale, the minnesota living with heart failure questionnaire (mlhfq), the perceived stress scale (pss), the 5x5 resilience scale, the brief cope, and a healthcare utilization survey. all participants will participate in a tailored problem-solving intervention designed to help manage heart failure-related problems experienced in the home over 12 weeks (weeks 1-4, 6, 8, 10, 12). follow-up data collection will occur at 3-months (post-intervention) and 6-, 12-, and 18-months. quantitative data on study variables will be collected using the following self-report surveys: spsirs, schfi, hfss, phq-9, gad, mlhfq, pss, 5x5 resilience scale, brief cope, and healthcare utilization. all data will be collected by a trained research assistant who will collect study data over the telephone and mark participants answers on a computerized data spreadsheet. possible treatment effectiveness on heart failure self-care, heart failure symptoms, healthcare utilization, depression, anxiety, quality of life, stress, resilience, coping, and differences among subgroups over the study period will be examined using multilevel modeling.

Eligibility criteria:
inclusion criteria: * age 18 years of age or older * us veteran * diagnosed with heart failure (reduced or preserved ejection fraction) * able to read, speak, and understand english * reliable telephone access exclusion criteria: • history of cognitive dysfunction

Keywords: heart failure problem-solving veterans self-care quality of life depression anxiety stress symptoms resilience