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Chronic Heart Failure · Journal article
International Journal of Nursing Studies Advances · July 14, 2026
Encouraging direction, but not yet definitive.
A secondary analysis of a randomized controlled trial found that a nurse-led age-friendly graded symptom-recognition intervention was associated with significant improvements in both self-care ability and task execution ability among older patients with chronic heart failure during the first 3 months after discharge, with interaction effects that grew larger over time. The results support the use of structured symptom-recognition support to strengthen post-discharge self-management capabilities, although the evidence is limited to surrogate behavioral measures and a single-centre population.
Secondary analysis of a randomized controlled trial, longitudinal mixed-effects design. Older patients with chronic heart failure recruited from a tertiary hospital; analysis focused on behavioral outcomes within the first 3 months after discharge. Intervention: Nurse-led age-friendly graded symptom-recognition intervention plus usual care. Compared with: Usual care alone. Tertiary hospital (Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, China).
Self-care ability: significant group × time interaction (F_interaction = 8.10, P < 0.001), with standardized interaction effect increasing from β ≈ 0.30 at 1 month to β ≈ 1.00 at 3 months Task execution ability: significant time effect (F_time = 36.19, P < 0.001) and interaction effect (F_interaction = 26.91, P < 0.001), with interaction effect moderate at 1 month (β ≈ 0.65) and large at 3 months (β ≈ 1.35) No significant group main effect for task execution ability (F_group = 0.01, P = 0.91), but significant main effect of group for self-care ability (F_group = 11.65, P < 0.001)
Behavioral outcomes (self-care and task execution ability) are surrogates; effects on hard clinical outcomes (hospitalization, mortality, quality of life) not reported No reporting of blinding, allocation concealment, dropout rates, or adverse events; baseline comparability between groups not stated
Clinicians caring for older heart failure patients should consider implementing structured, age-friendly symptom-recognition interventions during the vulnerable post-discharge transition period, as such support may enhance both self-care ability and concrete task execution. However, pending confirmation with larger samples and hard clinical outcomes (readmission, mortality), this evidence remains supportive of targeted nursing intervention rather than definitive guidance.
Secondary analysis of an RCT with sound design showing significant improvements in self-care and task execution ability over 3 months, but limited by surrogate behavioral endpoints, single-centre recruitment, and unclear sample size reporting.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians caring for older heart failure patients should consider implementing structured, age-friendly symptom-recognition interventions during the vulnerable post-discharge transition period, as such support may enhance both self-care ability and concrete task execution. However, pending confirmation with larger samples and hard clinical outcomes (readmission, mortality), this evidence remains supportive of targeted nursing intervention rather than definitive guidance.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Aim and objectives. To examine longitudinal changes in self-care ability and task execution ability among older patients with chronic heart failure following a nurse-led age-friendly graded symptom-recognition intervention.Background. Older patients with chronic heart failure often experience difficulties in symptom recognition, response selection, and sustained self-management after discharge. Although self-care has been widely emphasized in heart failure management, less is known about how nurse-led interventions influence the development of both self-care ability and task execution ability over time, particularly during the vulnerable post-discharge transition period.Design. This study was a secondary analysis based on a previously published randomized controlled trial protocol in older patients with chronic heart failure recruited from a tertiary hospital. Participants were originally assigned to either a nurse-led age-friendly graded symptom-recognition intervention plus usual care or usual care alone. The present analysis focused on behavioral outcomes within the first 3 months after discharge.Methods. Self-care ability and task execution ability were assessed at baseline, 1 month, and 3 months after discharge. Self-care ability was measured using the Chinese version of the European Heart Failure Self-care Behaviour Scale (EHFScBS-9), and task execution ability was evaluated using a structured task performance scale assessing key self-management tasks. Longitudinal trajectories were analysed using linear mixed-effects models.Results. For self-care ability, significant main effects of group and time were observed, along with a significant group × time interaction (F_group = 11.65, P < 0.001; F_time = 5.74, P = 0.003; F_interaction = 8.10, P < 0.001). The standardized interaction effect increased from modest at 1 month (β ≈ 0.30) to large at 3 months (β ≈ 1.00). For task execution ability, no significant group main effect was observed (F_group = 0.01, P = 0.91), whereas significant time and interaction effects were detected (F_time = 36.19, P < 0.001; F_interaction = 26.91, P < 0.001). The interaction effect was moderate at 1 month (β ≈ 0.65) and large at 3 months (β ≈ 1.35).Conclusions. A nurse-led age-friendly graded symptom-recognition intervention was associated with improved longitudinal patterns of both self-care ability and task execution ability among older patients with chronic heart failure. These findings suggest that structured symptom-recognition support may strengthen patients' ability to translate symptom cues into appropriate self-management actions during the vulnerable post-discharge transition period.
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