Effectiveness of Nursing Educational Program on Patients with Heart Failure in Sulaimani City

Abstract

Background: Heart failure, is inability of the heart to pump blood for the body's metabolic
needs. Globally, nurses are pivotal in health education, enhancing positive health outcomes and
overall healthcare effectiveness.
Aim: To evaluate the effectiveness of nursing educational program on patients with heart failure.
Methods: A quasi-experimental design enrolled 200 patients with heart failure at the Cardiac
Specialty Hospital in Sulaimani City from (August 2 - 2021, to February 8 - 2024). Stratified into
interventional (n=100) and control (n=100) groups, participants completed a comprehensive
questionnaire covering socio-demographics, clinical characteristics, and various assessments. The
nursing education program exclusively targeted the interventional group. Data were collected
through direct interviews, and analysis used Statistical Package for the Social Sciences version 26,
independent t test and Chi square.
Results: The average age of the participants was 68.3 ± 11.2 years. The intervention and control
groups were predominantly male, with 72% and 69% respectively. Each group initially had 100
patients, but the intervention group reduced to 94 and the control group to 90 due to mortalities
after the educational program. In terms of family history of heart failure, 77% of the intervention
group and 70% of the control group had a first-degree relative with the condition. Past medical
histories of diabetes mellitus were 32% in the intervention group and 42% in the control group.
Valvular heart disease was present in 37% of the intervention group and 40% of the control group.
Thyroid disorders were rare, with 93% and 94% of the intervention and control groups respectively
having no thyroid issues. Dyslipidemia was found in 59% of the intervention group and 63% of
the control group. Before the nursing intervention program, 37% of the intervention group and
34% of the control group were current smokers, with 12% and 11% being passive smokers,
respectively. After the program, current smokers reduced to 25% in the intervention group and
26% in the control group, while passive smokers remained the same. Initially, a significant
proportion of participants in both groups had no plans to quit smoking, but after the program, there
was a highly significant improvement in the intervention group (P value 0.002) compared to the
control group. Before the program, 44% of the intervention group and 52% of the control group
had been affected by COVID-19, with only 27% and 14% respectively having received the
vaccine. After the program, vaccine uptake increased to 42.6% in the intervention group and 14.4%
in the control group. There were no significant differences between the groups before and after the
program regarding influenza vaccination, as almost none had heard of it. Before the program,
hospital admissions for heart failure were 9%, 10%, 22%, and 30% for zero, one, two, and three
or more times respectively, in both groups. After the program, the intervention group showed
notable improvements compared to the control group. Before the program, 50% of the intervention
group and 44% of the control group were in class III heart failure, which changed to 47.9% and
38.9% respectively after the program. The intervention group saw a decrease in class IV heart
failure from 11% to 5.3%, while the control group increased from 12% to 28.9%.
Conclusions: The implementation of the nursing educational program showed highly significant
differences (p= 0.001) between the two groups such as smoking cessation, administer COVID-19
vaccination, NYHA classification and admitting hospital during the last 3 months. The
improvement of intervention group was better and higher than control group.