Occupational Performance Coaching on Health Self-Care Behavior and Activity Participation for Adults With Heart Failure: A Randomized Controlled Trial

IMPORTANCE: Patients with heart failure (HF) experience restrictions in their activity participation. Health self-care behavior (HSCB) among patients with HF is an essential component of managing HF symptoms. OBJECTIVE: To assess the effect of occupational performance coaching (OPC) on improving activity participation and HSCB among patients with HF. DESIGN: Single-blind randomized controlled trial. SETTING: Outpatient HF clinic in Rajaie Cardiovascular, Medical & Research Center (Tehran, Iran). PARTICIPANTS: Forty-four adults with HF randomized into two groups (1:1 ratio). OUTCOMES AND MEASURES: All participants received the usual health self-care education, and the intervention group also received eight weekly sessions of the OPC intervention. HSCB and activity participation were the primary outcomes. Primary outcomes and secondary outcomes (depression, quality of life, self-efficacy, cognitive level, fatigue, social support, functional capacity, and activities of daily living) were collected at baseline and 8 and 12 wk postintervention. RESULTS: The results of two-way repeated-measures analysis of covariance for three assessment time points with the primary and secondary outcomes showed a significant improvement in primary outcomes and depression (p < .05) among the intervention group. There were no significant between-groups differences in the other outcomes (p > .05). CONCLUSIONS AND RELEVANCE: These findings indicate that an 8-wk OPC intervention could enhance HSCB and activity participation and reduce depression among patients with HF. Therefore, integrating OPC into standard care may improve the well-being of patients with HF. Moreover, the results suggest that the participation-based interventions have the potential to enhance HSCB among HF patients. Plain-Language Summary: Occupational performance coaching (OPC) is a client-centered occupational therapy intervention designed to enhance behavior change and activity participation by promoting the development of healthy habits and routines. This study presents important insights into the impact of the OPC intervention on patients with heart failure (HF). Our findings indicate that the OPC intervention can significantly improve health self-care behavior, increase participation, and reduce depression among HF patients.