Evaluation of an assessment tool to guide heart failure support

INTERVENTION: The study intervention is the application of the screening tool by a CHF nurse clinician. The screening tool assesses physical, cognitive and emotional functioning as key determinants of CHF self‐care. For each of the three domains the patient’s level of functioning is quantified as low, medium or high. In this manner, low functioning indicates the individual is at greater risk of inadequate self‐care ability and will require more intensive strategies than an individual with high functioning. The screening tool is administered to each participant once only and is administered by the CHF nurse at their first home visit following recruitment to the study. The screening tool takes approximately10 minutes to administer. The screening tool provides the nurse clinician with recommendations on the frequency of contact, symptom monitoring and most appropriate educational and counselling approaches to adopt in promoting and supporting patient self‐care. For example, if a patient is screened as ‘low’ self‐care ability on the cognitive domain it is recommended that the CHF nurse has weekly contact with the patient via home visits or telephone support. The overall duration of the intervention is 3 months. CONDITION: Chronic Heart Failure and patient self‐care PRIMARY OUTCOME: Patients in the intervention groups will have significantly higher medication adherance scores Patients in the intervention groups will have significantly higher self‐care maintenance, management and confidence scores from the Self‐Care Heart Failure Index. SECONDARY OUTCOME: All‐cause hospitalisation and death Health related quality of life (SF‐12) INCLUSION CRITERIA: Participants will be 18 years of age or older and have a confirmed diagnosis of CHF. Confirmation of the diagnosis will be from: 1) symptoms and clinical features of congestion that occur at rest or on minimal effort (dyspnoea, orthopnea, paroxysmal nocturnal dyspnoea, fatigue, palpitations, elevated jugular venous pressure, cardiomegaly, lung crepitations, hepatomegaly, oedema); 2) either objective evidence of underlying structural cardiac dysfunction that impairs the ability of the ventricle to fill with or eject blood or an elevated plasma level of B‐type natriuretic Peptide (BNP), >200 pg/mL. Participants will have been referred and enrolled into the CHFMP which is conducted across Eastern health.