The following article is a part of conference coverage from the American Psychiatric Nurses Association (APNA) 34th Annual Conference, held online from September 30 to October 4, 2020. The team at the Clinical Advisor will be reporting on the latest news and research conducted by leading nurses in psychiatry. Check back for more from APNA 2020.


In patients with heart failure (HF), an appropriate intervention can improve self-care, even in patients with depressive symptoms, according to study results presented at the American Psychiatric Nurses Association (APNA) 34th Annual Conference, held online from September 30 to October 4, 2020.

Compared with patients without HF, patients with HF often experience symptoms of depression, resulting in poorer outcomes and quality of life.  The objective of this study was to determine whether symptoms of depression, which are associated with lower self-care among patients with HF, are improved with self-care interventions.

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In this study, researchers evaluated 614 patients with HF at hospitals in California, Kentucky, and Nevada. One-third of patients (41% women, mean age 66 years) had depressive symptoms at baseline. Patients were assigned to 1 of 3 study groups: usual care (n=213), Fluid Watchers LITE (n=203), or Fluid Watchers PLUS (n=198). The groups were well matches for gender, age, and race.

The 2 intervention groups received face-to-face self-care education sessions on HF plus either 2 follow-up phone calls (LITE) or biweekly calls (PLUS). Data were collected at baseline, 3 months, and 12 months. Researchers used the Patient Health Questionnaire-9 to measure depressive symptoms and examined the impact of the interaction between depressive symptoms and the type of self-care intervention received for HF using the European HF Self-Care Behavior Scale.

The researchers reported significant improvements in self-care among the study group (P =.019).  The greatest improvement in self-care was observed in the Fluid Watchers PLUS group. The best self-care was observed in patients without symptoms of depression (P =.006).

The study researchers concluded that an appropriate self-care intervention may improve self-care in patients with HF, even in patients with symptoms of depression.

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Alosais O, Dracup K, Pelter M, Moser DK. Do depressive symptoms impact the outcome of heart failure self-care educational interventions? Presented at: APNA 34th Annual Conference; September 30-October 4, 2020.  Poster 126.