Razavi Journal of Medicine

Razavi Journal of Medicine

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

Articles in Press

Document Type : Original Article

Authors
Maryam Marhounkar 1
Marzieh Jahani Sayad Noveiri 2
Saman Maroufizadeh 3
Zeinab Borhani 4
Mohammad Taghi Moghadamnia 5
1 MSN, Department of Medical- Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
2 Assistant Professor, Department of Medical Surgery, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
3 Assistant Professor, Department of Biostatistics and Epidemiology, School of Health, Guilan University of Medical Sciences, Rasht, Iran.
4 Department of Medical- Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
5 Associate Professor, Department of Medical-Surgical Nursing, School of Nursing, Guilan University of Medical Sciences, Rasht, Iran.
10.30483/rjm.2026.254786.1533
Abstract
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.
Keywords
Heart failure
home-based self-care
nurse-led
quality of life

Acknowledgement: We would like to express our deep gratitude to the Vice Chancellor for Research of Guilan University of Medical Sciences, the nurses of Dr. Heshmat Rasht Hospital, Dr. Fatemeh Mudab, and Dr. Samira Arami, as well as the patients with heart failure who helped in the progress of this study.

Availability of data and materials: Data are available from the corresponding author upon reasonable request.

Competing of interest: All the authors declare that they have no conflicts of interest.

Funding: None.

Consent for publication: Not Applicable.

Ethics approval and consent to participate: We confirm that all experiments conducted in this study were performed in accordance with the Declaration of Helsinki. The study focused solely on implementing a self-care education program, and no changes were made to the patients' treatment plans. This study began after approval by the Ethics Committee of the Deputy Research of Guilan University of Medical Sciences (GUMS), with the ID IR.GUMS.REC.1402.008 was obtained on April 19, 2023, and the study was registered with the IRCT. Informed consent was subsequently obtained from the participants. The data, including identifying information, were kept confidential, and participants were free to participate in the study or withdraw. Trial registration: IRCT20101019004971N6 on 2023-05-09.

Authors' contributions: M.M: Collecting data and editing the article. M.J.S.N: Supervising the entire execution of the research, writing, and editing the article. S.M: writing the results and conducting statistical analysis. Z.B: Collecting data. M.T.M: Supervising the entire execution of the research and editing the article. All authors have approved the final manuscript.

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Razavi Journal of Medicine

Articles in Press, Accepted Manuscript
Available Online from 17 July 2026