A pilot randomized clinical trial of a teamwork intervention for heart failure care dyads.
Elliane Irani, Atsadaporn Niyomyart, Mary A Dolansky and 4 others
PMID 34407481WHAT IT FOUND
For 27 HF patient-caregiver dyads discharged home, four weekly tablet teamwork sessions were feasible and acceptable.
Scores for relationship, self-confidence and quality of life tended to favor the teamwork condition, but this pilot did not test effectiveness.
Key findings
01The analysed sample was 27 patients and 27 caregivers who completed baseline and follow-up data.
02Both groups used a tablet for four 10 to 15 minute sessions, one per week, but only half adhered to the weekly schedule.
03Post-intervention scores tended to favor eSMART-HF for patients and caregivers, but significance tests were not calculated.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was small: 27 patients and 27 caregivers were analysed, and no significance tests were calculated for between-group outcomes. Recruitment was low and selective: 742 patients were screened, only 37 dyads agreed to participate, and exclusions removed patients with implanted left ventricular assist devices, heart transplant or active listing, hospice or extended rehabilitation referral, cognitive impairment, or planned cardiac surgery. Most patients (67.9%) and caregivers (71.4%) self-identified as Black, and all caregivers had to live with the patient, so results may not apply to other settings or family arrangements. Patients and caregivers who agreed to participate may have had better relationships than those who refused or were lost to follow-up. At baseline, caregivers in the control group had higher self-efficacy and better mental quality of life than caregivers in the intervention group, which may have influenced the reported preliminary effects. Follow-up was only one week after the final session, so sustained effects are unknown. eSMART-HF combined didactic presentations, experiential exercises, printed workbooks, goal setting, communication training, emotion management, mutual respect and progress review, tablet access, and weekly reminders, so the contribution of any single component cannot be separated.
Declared interests
No conflicts of interest were declared.
The easy way to misread this
Do not read the favorable post-intervention scores as proof that eSMART-HF works. The study was a pilot with 27 patients and 27 caregivers, no significance tests were calculated, caregivers in the control group had higher baseline self-efficacy and mental quality of life, and eSMART-HF combined didactic presentations, experiential exercises, printed workbooks, goal setting, communication training, emotion management, mutual respect and progress review, tablet access, and weekly reminders, so the contribution of any single component cannot be separated.