Context. Heart failure (HF) patients experience high burden of physical symptoms during their disease trajectory.Objective. To evaluate the effects of Motivational Interviewing (MI) on the burden of physical symptoms in HF patients.Methods. We performed a secondary analysis of data from the MOTIVATE-HF randomized controlled trial. A sample of 510 patients (median 74 years, 58% male) and their caregivers (median 55 years, 75.5% female) was randomly allocated to Arm 1 (MI only for patients), Arm 2 (MI for patients and caregivers), and Arm 3 (standard of care). The MI intervention consisted of one face-to-face session plus three telephone calls conducted within two months from enrollment. Symptoms' burden was assessed with the Heart Failure Somatic Perception Scale (HFSPS) with the dimensions of Chest Discomfort, Dyspnea, Early and subtle and Edema. Data were collected at baseline and at 3, 6, 9, and 12 months after enrollment.Results. At 12 months, Chest Discomfort improved in Arms 1 and 2 vs Arm 3 (Delta: -8.13, 95% CI: -14.61; -1.65). Dyspnea improved in Arms 1 and 2 vs Arm 3 both at 9 and 12 months (Delta: -7, 95% CI: -13.18; -0.82 and -6.78, 95% CI: -13.19; -0.38); HFSPS total score improved in Arm 1 and Arm 2 vs Arm 3 at 9 months (Delta: -4.55, 95% CI: -9.05; -0.05). Over 1 year, Chest Discomfort and HFSPS total score in Arm 2 improved compared to Arm 3 (beta=-2.61, 95% CI: -4.21; -1.00, P = 0.0015 and beta=-1.35, 95% CI: -2.50; -0.21, P= 0.02).Conclusion. MI reduces the burden of physical HF symptoms, particularly when caregivers are involved in the intervention. (C) 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Caggianelli, G., Iovino, P., Rebora, P., Occhino, G., Zeffiro, V., Locatelli, G., et al. (2022). A Motivational Interviewing Intervention Improves Physical Symptoms in Patients with Heart Failure: A Secondary Outcome Analysis of the Motivate-HF Randomized Controlled Trial. JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 63(2), 221-229.e1 [10.1016/j.jpainsymman.2021.09.006].

A Motivational Interviewing Intervention Improves Physical Symptoms in Patients with Heart Failure: A Secondary Outcome Analysis of the Motivate-HF Randomized Controlled Trial

Zeffiro V.;Alvaro R.;Vellone E.
2022-01-01

Abstract

Context. Heart failure (HF) patients experience high burden of physical symptoms during their disease trajectory.Objective. To evaluate the effects of Motivational Interviewing (MI) on the burden of physical symptoms in HF patients.Methods. We performed a secondary analysis of data from the MOTIVATE-HF randomized controlled trial. A sample of 510 patients (median 74 years, 58% male) and their caregivers (median 55 years, 75.5% female) was randomly allocated to Arm 1 (MI only for patients), Arm 2 (MI for patients and caregivers), and Arm 3 (standard of care). The MI intervention consisted of one face-to-face session plus three telephone calls conducted within two months from enrollment. Symptoms' burden was assessed with the Heart Failure Somatic Perception Scale (HFSPS) with the dimensions of Chest Discomfort, Dyspnea, Early and subtle and Edema. Data were collected at baseline and at 3, 6, 9, and 12 months after enrollment.Results. At 12 months, Chest Discomfort improved in Arms 1 and 2 vs Arm 3 (Delta: -8.13, 95% CI: -14.61; -1.65). Dyspnea improved in Arms 1 and 2 vs Arm 3 both at 9 and 12 months (Delta: -7, 95% CI: -13.18; -0.82 and -6.78, 95% CI: -13.19; -0.38); HFSPS total score improved in Arm 1 and Arm 2 vs Arm 3 at 9 months (Delta: -4.55, 95% CI: -9.05; -0.05). Over 1 year, Chest Discomfort and HFSPS total score in Arm 2 improved compared to Arm 3 (beta=-2.61, 95% CI: -4.21; -1.00, P = 0.0015 and beta=-1.35, 95% CI: -2.50; -0.21, P= 0.02).Conclusion. MI reduces the burden of physical HF symptoms, particularly when caregivers are involved in the intervention. (C) 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
2022
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/45 - SCIENZE INFERMIERISTICHE GENERALI, CLINICHE E PEDIATRICHE
English
Motivational interviewing
heart failure
self-care
symptoms
Caregivers
Dyspnea
Female
Humans
Male
Heart Failure
Motivational Interviewing
Caggianelli, G., Iovino, P., Rebora, P., Occhino, G., Zeffiro, V., Locatelli, G., et al. (2022). A Motivational Interviewing Intervention Improves Physical Symptoms in Patients with Heart Failure: A Secondary Outcome Analysis of the Motivate-HF Randomized Controlled Trial. JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 63(2), 221-229.e1 [10.1016/j.jpainsymman.2021.09.006].
Caggianelli, G; Iovino, P; Rebora, P; Occhino, G; Zeffiro, V; Locatelli, G; Ausili, D; Alvaro, R; Riegel, B; Vellone, E
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/302209
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