King's Theory-Based Multicomponent Interventions in Heart Failure Patient Rehabilitation

Registry record from ClinicalTrials.gov (NCT07917052). This is a study registration, not published results. Lead sponsor: Saglik Bilimleri Universitesi. Recruitment status: NOT_YET_RECRUITING. Phase: NA. Study type: INTERVENTIONAL. Enrollment: 40 participants (ESTIMATED). Conditions: Heart Failure, Cardiac Rehabilitation. Interventions: BEHAVIORAL: King's Theory of Goal Attainment; OTHER: Standard Care (in control arm). Primary outcome measures: Change in Self-Care Behaviors , Beginning (Week 1 - Pre-test), Week 6 (Mid-term Assessment), and Week 12 (Post-test).; Change in Total Physical Activity (MET-minutes/week) , Beginning (Week 1 - Pre-test), Week 6 (Mid-term Assessment), and Week 12 (Post-test).; Change in Physical Activity Classification , Week 1 (Baseline), Week 6, and Week 12.; Change in Daily Sitting Time (minutes/day) , Week 1 (Baseline), Week 6, and Week 12.. Brief summary: Heart failure is a chronic health condition associated with high morbidity and hospital readmission rates, negatively affecting patients' self-care behaviors, physical activity levels, and quality of life. Although cardiac rehabilitation programs offer significant benefits, the sustainability of self-care behaviors in the home environment remains a major challenge. There is a limited number of theory-based intervention studies that integrate components such as spousal support, structured education, and telemonitoring. This study aims to examine the impact of an intervention-structured according to Imogene King's Theory of Goal Attainment and incorporating spousal support, education, and telemonitoring-on the self-care behaviors and physical activity levels of patients with heart failure during their rehabilitation process. The study will be conducted as a randomized controlled trial with a pre-test/post-test control group design. The sample will consist of patients with NYHA Class II-III heart failure who are enrolled in a cardiac rehabilitation program. Ethical approval and institutional authorization will be obtained prior to the study. At the outset, all participants will undergo a pre-test, and their sociodemographic and clinical data will be assessed. The intervention group will receive face-to-face education during the first two weeks to initiate a goal-setting process, followed by weekly video-based educational modules over the next six weeks. Throughout this period, patients' symptoms, weight, medication adherence, and physical activity levels will be monitored via WhatsApp-based telemonitoring and weekly telephone calls. An interim assessment will be conducted at the sixth week; the intervention will span a total of 12 weeks, concluding with a post-test at the 12th week. The control group will receive only routine care. The video educational modules will be prepared in alignment with the current ESC and AHA/ACC/HFSA guidelines and developed using AI-powered digital tools, such as Google Flow and NotebookLM. Data will be collected using the European Heart Failure Self-Care Behaviour Scale, the International Physical Activity Questionnaire, the Perceived Partner Responsiveness Scale, and a Weekly Goal and Data Tracking Form. The study is expected to contribute to the development of a feasible and sustainable nursing care approach within the cardiac rehabilitation process.