Self-care for people with heart failure: the importance of tele-nursing in the COVID-19 pandemic.
Micaelle Costa Gondim, Ricardo Costa da Silva, Ana Karoline Barbosa da Silva and 4 others
PMID 39140562WHAT IT FOUND
People with heart failure and recent readmissions reported feeling abandoned after discharge, with little guidance on diet, medication or symptom monitoring.
Telenursing consultations offered a rare chance to be heard, ask questions and rebuild trust with care teams.
Key findings
01Most participants had no contact with health professionals after discharge to answer questions or give guidance on daily self-care, and received little individualised education during hospitalisation.
02Participants lacked confidence and autonomy to manage decompensation, for example not knowing whether to take extra diuretics when they developed swelling.
03The telenursing interview itself functioned as a therapeutic encounter, with participants expressing a strong need to be listened to and to have their doubts and anxieties addressed.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Small sample of 16 people from a single public hospital in one region of Brazil, so findings may not transfer to other health systems or populations. Participants were selected because they had been readmitted, so the study describes a high-risk group and may not represent heart failure patients who avoid rehospitalisation. Several eligible patients could not be contacted due to outdated records, and one interview was lost to connection failure, which may have biased the sample toward those with better phone access. The nurse researcher provided answers to participants' questions at the end of each interview, which may have shaped what was said during the conversation. Some participants struggled with video or audio calls, so the experience of people with limited digital access is under-represented.
Declared interests
Funded in part by CAPES (Brazilian federal agency for graduate training). The publication was part of a PAHO/WHO Collaborating Centre for Nursing Research Development activity. No commercial conflicts of interest are declared.
The easy way to misread this
Do not read this as evidence that telenursing improves heart failure outcomes. The study describes what patients said they needed during a pandemic period of reduced services; it did not measure readmissions, mortality or self-care behaviour change, and no control group was used.