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Effects of an autonomy-supportive intervention programme (ASIP) on self-care, quality of life, and mental health in heart failure patients: a randomized controlled trial

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Abstract

Purpose

Patients with heart failure (HF) possess low self-care activation and motivation, leading to a deprived quality of life and adverse mental health conditions. To this end, self-determination theory emphasizes that autonomy-supportive interventions (ASI) can stimulate intrinsic motivation and improve behaviors and quality of life. Nevertheless, studies that focused on ASI for HF are inadequate. This study aims to evaluate the effects of an HF-ASIP on self-care, quality of life and mental health in HF patients.

Methods

In a two-arm randomized controlled trial, the participants are randomly allocated to the intervention (n = 41) or control (n = 41) groups. The intervention group received routine care and participated in an 8-week HF-ASIP, including individual education and consultation sessions. In contrast, the control group received only routine care. The primary outcome includes self-care management, while the secondary outcomes include self-care maintenance, quality of life, mental health, and motivation. After measuring the outcomes at baseline (T0), 4-week (T1), 8-week (T2), and 12-week (T3) follow-up, the intervention effects are assessed using the generalized equation models.

Results

The outcomes indicated that self-care management (T2: P = 0.001; T3: P = 0.016), self-care maintenance (T2: P = 0.003; T3: P = 0.001), depression (T2: P = 0.007; T3: P = 0.012), anxiety (T2: P = 0.001; T3: P = 0.012), MLHFQ total score (T1: P = 0.004; T2: P < 0.001; T3: P = 0.001), autonomous motivation (T2: P = .0.006; T3: P = 0.002) showed statistically difference between the groups.

Conclusion

In summary, the 8-week HF-ASIP significantly improved the attributes of self-care, quality of life, mental health, and motivation in HF patients, suggesting the potential for practical intervention effect.

Trial registration

ChiCTR2100053970.

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Data availability

The data that support the findings of this study are available from the corresponding author, [Xiaoying Zang], upon reasonable request.

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Acknowledgements

The authors would like to thank all the subjects who participate in our study and all experts and hospitals for supporting this study.

Funding

This work was supported by grants from National Natural Science Foundation of China (71904143, 71974142).

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Author notes

  1. Yanting Li and Weiling Yang have been contributed equally to this work.

Authors and Affiliations

  1. School of Nursing, Tianjin Medical University, N.22 Qixiangtai Rd, Heping District, Tianjin, 300070, China

    Yanting Li, Weiling Yang, Yuanyuan Qu, Xiaonan Zhang & Xiaoying Zang

  2. Tianjin Medical University General Hospital, Tianjin, China

    Mei Lin

  3. The Second Hospital of Tianjin Medical University, Tianjin, China

    Li Fu & Cuicui Wang

  4. School of Nursing, Fujian Medical University, Fujian, China

    Pingping Qiu

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  1. Yanting Li
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Contributions

Conceptualization, Methodology were performed by YL, WY, YQ, PQ and XZ. Investigation were performed by YL, YQ, CW. Supervision, Visualization were performed by WY, PQ and XZ. Data collection and analysis were performed by XZ, ML and LF. Language polishing and sentence revision were performed by PQ and XZ. The first draft of the manuscript was written by YL and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Pingping Qiu or Xiaoying Zang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Li, Y., Yang, W., Qu, Y. et al. Effects of an autonomy-supportive intervention programme (ASIP) on self-care, quality of life, and mental health in heart failure patients: a randomized controlled trial. Qual Life Res 32, 3039–3052 (2023). https://doi.org/10.1007/s11136-023-03467-1

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