NIOSHTIC-2 Publications Search

A motivational counseling approach to improving heart failure self-care: mechanisms of effectiveness.

Riegel B; Dickson VV; Hoke L; McMahon JP; Reis BF; Sayers S
J Cardiovasc Nurs 2006 May-Jun; 21(3):232-241
Background: Self-care is an integral component of successful heart failure (HF) management. Engaging patients in self-care can be challenging. Methods: Fifteen patients with HF enrolled during hospitalization received a motivational intervention designed to improve HF self-care. A mixed method, pretest posttest design was used to evaluate the proportion of patients in whom the intervention was beneficial and the mechanism of effectiveness. Participants received, on average, 3.0 T 1.5 home visits (median 3, mode 3, range 1Y6) over a three-month period from an advanced practice nurse trained in motivational interviewing and family counseling. Quantitative and qualitative data were used to judge individual patients in whom the intervention produced a clinically significant improvement in HF self-care. Audiotaped intervention sessions were analyzed using qualitative methods to assess the mechanism of intervention effectiveness. Results: Congruence between quantitative and qualitative judgments of improved self-care revealed that 71.4% of participants improved in self-care after receiving the intervention. Analysis of transcribed intervention sessions revealed themes of 1) communication (reflective listening, empathy); 2) making it fit (acknowledging cultural beliefs, overcoming barriers and constraints, negotiating an action plan); and, 3) bridging the transition from hospital to home (providing information, building skills, activating support resources). Conclusion: An intervention that incorporates the core elements of motivational interviewing may be effective in improving HF self-care, but further research is needed.
Humans; Men; Women; Attitude; Behavior; Education; Cardiovascular-system; Cardiovascular-function; Cardiovascular-disease; Cardiopulmonary-function; Cardiac-function; Cardiovascular-system-disorders; Age-groups; Nurses; Racial-factors; Demographic-characteristics; Sex-factors; Author Keywords: heart failure; mixed methods; motivational interviewing; naturalistic decision-making; patient education; self-care
Dr. Barbara Riegel, School of Nursing, Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA 19104-6096
Publication Date
Document Type
Journal Article
Email Address
Funding Type
Fiscal Year
Identifying No.
Issue of Publication
Source Name
The Journal of Cardiovascular Nursing
Performing Organization
University of Pennsylvania
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division