Proposed Topic (Most preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Proposed Topic (Second preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patients / carers / community to improve efficiency / quality of care)
Authors (including presenting author) :
Mak PT(1), Ho YN(1), Ho KK(1), Wong YPJ(1), Dr. Fan YYK(2)
Affiliation :
Occupational Therapy Department, Grantham Hospital, (2) Cardiac Rehabilitation Centre, Cardiac Medical Unit, Grantham Hospital
Introduction :
Heart failure (HF) has led to more than 17000 hospitalizations in Hong Kong in 2020 (Department of Health, 2022). Its debilitating symptoms such as shortness of breath and fatigue affect patients’ independence in daily function (Norberg et al., 2014) and give rise to the need of developing occupational therapy (OT) service in HF rehabilitation in Hong Kong.
Objectives :
An OT self-management program was developed and launched in October 2021 in Grantham Hospital and a pilot study is carried out to evaluate the effectiveness of the program in enhancing HF patients’ self-care skills, self-care self-efficacy and psychological health.
Methodology :
The program contains 12-16 individual rehabilitation sessions with several themes including disease knowledge, lifestyle redesign, dyspnea management, fatigue management, stress management and health qigong - Baduanjin. Education booklets, worksheets, simulated functional tasks and app-based educational video were used to improve patients’ symptoms management skills in daily living. The 3 assessments including Self-Care of Heart Failure Index - Chinese Version (SCHFI-CV), Self-Care Self-Efficacy Scale (SCSES) (Yu et al., 2010), and Hospital Anxiety and Depression Scale (HADS) (Leung et al., 1999) served as outcome measures. SCHFI-CV was used to evaluate patients’ self-care skills which contains 3 sub-scales: self-care maintenance, measuring behaviors to maintain HF stability; symptoms perception, measuring monitoring behavior; and self-care management, assessing the response to symptoms. SCSES and HADS were used to evaluate self-care self-efficacy in chronic illness and psychological health respectively.
Result & Outcome :
From 1st October 2021 till 12th January 2023, 50 patients participated in the self-management program and 24 of them had completed the whole program. A Wilcoxon signed rank test was applied for data analysis. Statistically significant difference was found in all sub-scales in Self-Care of Heart Failure Index- Chinese version (SCHFI-CV): self-care maintenance; p=0.013, symptoms perception; p=0.014, and self-care management; p=0.001. Self-Care Self-Efficacy Scale (SCSES); p= 0.001, and Hospital Anxiety and Depression Scale (HADS)-Anxiety; p= 0.014, Depression; p= 0.006.
This pilot study showed that OT self-management program could improve HF patients’ self-management skills and psychological health. Further studies with larger sample size are required to determine the optimal treatment prescription of self-management program on HF patient.
