Intervention
heart failure
DISEASE, CHRONIC HEART FAILURE, HEART FAILURE
The researcher visited the coronary care units (CCUs) of hospitals affiliated with the Kerman University of Medical Sciences to conduct the study and obtained the required approvals. Using the convenience sampling technique, the researcher divided the selected eligible patients into intervention and control groups. The patients were given the necessary information about the research objectives, and their written informed consent was obtained.The older adults in the intervention group attended 8 individual sessions for one and a half hours twice a week. The home-based palliative heart failure program was conducted for one month with prior arrangements with the patients. The older adults in the control group only received routine care during this time. The intervention was delivered by one of the authors who was a senior cardiovascular nurse and was familiar with the interventions. The program focused on information about the disease, mental and physical aspects of self-care for old client and their families, an examination of coping strategies in stressful situations, and techniques to boost self-confidence (Table The content of the HBPC programDuring the intervention, the researcher performed the nursing assessment, education, and counseling and provided emotional support to patients. At the first visit, the researcher assessed the patients’ knowledge and abilities in self-management, their family support system, and their educational and counseling needs including symptoms and self-care of heart failure. An educational brochure was also provided to the patients. The brochure provided some instructions about heart failure, symptom management and monitoring, medication use, and the date of follow-up. The first face-to-face intervention session focused on enhancing participants’ knowledge about the effect of home-based palliative care on heart failure.The researcher would provide emotional support to patients, encouraged them to express their feelings, listened actively to patients’ responses, reassured the patients that their feelings were normal, and supported them in taking small steps to resolve the problem. In addition, the researchers provided 24-h phone calls for the participants to help them solve their problems. Every week after 2 face-to-face session interventions, the researchers contacted the patients by phone at home to assess potential problems and to make an appointment for the next intervention. Finally, the follow-up evaluations conducted after the 8The researcher completed the questionnaire for the intervention and control groups before the first session (before the intervention) and after the last session (after the intervention). The researcher re-completed the questionnaires for the intervention and control groups over the phone at the scheduled times after one month had passed (follow-up). The content of the intervention was constructed based on the guide for the care of patients with advanced chronic heart failure at home, which was compiled by the Secretariat of the Strategic Council for the Development of Health Guidelines of the Ministry of Health and Medical Education of Iran. In designing the intervention, the clinical guidelines for the management of chronic heart failure, which were compiled by the Department of Standardization and Compilation of Clinical Guidelines and the Office of Technology Evaluation, Standardization and Health Tariff of the Ministry of Health and Medical Education of Iran, were used. Also, the content of the intervention is based on the country's ethical guidelines on the subject of supportive palliative care in patients at the end of life, which were prepared by the Medical Ethics Department of the Endocrine and Metabolism Research Institute of Tehran University of Medical Sciences and supported by the World Health Organization Office in the Ministry of Health and Medical Education of Iran. Finally, the validity and caliber of the intervention were assessed by palliative care specialists at Kerman University of Medical Sciences.