Mashhad Razavi Hospital Razavi Journal of Medicine 3115-753X 14 4 2026 10 01 Effect of a Four-Week Nurse-Led Home-Based Self-Care Program on Quality of Life and Physiological Outcomes in Patients with Heart Failure: A Randomized Controlled Trial 49 63 118639 10.30483/rjm.2026.254786.1533 EN Maryam Marhounkar MSN, Department of Medical- Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran Marzieh Jahani Sayad Noveiri Assistant Professor, Department of Medical Surgery, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran. 0000-0002-2864-3003 Saman Maroufizadeh Assistant Professor, Department of Biostatistics and Epidemiology, School of Health, Guilan University of Medical Sciences, Rasht, Iran. Zeinab Borhani Department of Medical- Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran. Mohammad Taghi Moghadamnia Associate Professor, Department of Medical-Surgical Nursing, School of Nursing, Guilan University of Medical Sciences, Rasht, Iran. Journal Article 2026 05 02 Background: Heart failure (HF) management necessitates effective post-discharge transition. Despite the importance of transitional care, there is limited evidence on the effectiveness of nurse-led home-based self-care programs for patients with heart failure in Iranian post-discharge settings. Objectives: This study evaluated the impact of a nurse-led home self-care program on the quality of life (QoL) and physiological indicators of patients with HF. Methods: This randomized controlled trial included 50 patients hospitalized at Dr. Heshmat Educational and Medical Center (Rasht, Iran), who were allocated to intervention and control groups using permuted-block randomization with allocation concealment via sealed opaque envelopes (SNOSE). The intervention group received a bedside educational program comprising seven modules, each lasting 5–15 minutes, followed by four weeks of post-discharge tele-nursing delivered through weekly 15-minute calls. The control group received standard hospital care. Of the 58 patients initially assessed, 50 were included in the final analysis. Outcomes were measured using the SF-12, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and physiological parameters. Data were analyzed using paired t-tests and ANCOVA. Results: The participants had a mean age of 60.00 ± 8.87 years (mostly male). After adjusting for baseline values, there were no significant between-group differences in heart failure-specific QoL (MLHFQ: adjusted mean difference -6.7, 95% CI -15.9 to 2.6, P=0.154) or general QoL (adjusted mean difference 0.1, 95% CI -1.4 to 1.6, P=0.891). However, pulse rate was significantly lower in the intervention group (adjusted mean difference: -9.8 bpm; 95% CI: -16.8 to -2.8; P=0.007). No significant adjusted differences were observed in systolic/diastolic blood pressure, respiratory rate, or oxygen saturation Conclusion: While the four-week nurse-led self-care program did not significantly improve QoL scores, it was associated with a significant reduction in resting pulse rate. This structured tele-nursing model provides a feasible framework for post-discharge management. Future studies with longer follow-up periods are recommended to evaluate potential long-term effects on quality of life and clinical outcomes.

https://journal.razavihospital.ir/article_118639_9abf214910c5c4ed8ac014f14d5026e9.pdf