Dyadic intervention to improve heart failure self-care adherence

Objective: To develop a dyadic nursing intervention to promote self-care adherence in adults with heart failure.Methods: This intervention development study was conducted in three phases: 1) narrative literature review; 2) qualitative interviews with dyads and professionals; 3) theoretical integration with existing models.Results: In phase one, a literature review identified 11 factors associated with poor self-care adherence, with the most important being sleep problems, limited knowledge, low self-efficacy,mood disorders, and caregiver characteristics. In phase two, eight interviews with health professionals and 15 heart failure patients, plus their family caregivers, were analyzed. Findings suggest that a text-message–based dyadic intervention would be well-received and useful for promoting self-care among both professionals anddyads. Consequently, the intervention’s components—objectives, activities, delivery mode, and frequency—were defined. In phase three, a theory was developed by integrating the Theory of Self-Care in Heart Failure and the Theory of Caregiver Contribution to Self-Care, creating a framework that explains how the intervention could improve adherence through educational, motivational, behavioral, and emotional elements. Conclusion: A dyadic nursing intervention based on text messaging was developed to promote self-care adherence in adults with heart failure. The development included identifying critical factors through a literature review, validating acceptability with dyads and professionals, and integrating theoretical models of self-care. The designedintervention has the potential to improve self-care and health outcomes in dyads. Next steps include developing a structured intervention manual and evaluating it through a clinical trial.