Content validation of an heart failure self-care program for hospitalized patients: a modified e-Delphi study

Effective management of heart failure requires both pharmacological and non-pharmacological strategies with an emphasis on self-care behaviours. Nurses play a crucial role in promoting self-care, especially during hospitalisation, when early intervention can improve the outcomes. Despite the importance of effective self-care in heart failure, there is no clear consensus on which aspects of self-care should be prioritized for hospitalized individuals. The objective is to validate a self-care program tailored to hospitalized patients with heart failure.

A modified e-Delphi method was used to achieve consensus on the objectives of the program and the interventions to achieve them. These items were submitted to a panel of 37 experts who were invited to participate in two Delphi rounds. 29 Portuguese specialized rehabilitation nurses answered the questionnaire in the first round, and 27 in the second round. All participants worked in a Portuguese hospital setting. In the first round, consensus was reached on 23 objectives and 60 interventions, with two interventions eliminated, which were related to the physical exercise component of the program. The final program included 23 objectives and 60 interventions.

The validated self-care program offers a comprehensive framework for managing heart failure during hospitalisation with a focus on early intervention. The components that should integrate it and enhance self-care skills are awareness, engagement, hope, knowledge about the disease and treatment, self-care maintenance, self-care monitoring, and self-care management. It equips nurses with effective tools to promote self-care and further studies are planned to test its clinical effectiveness.