ArticleInternational journal of nursing studies advances2026
Trajectories of self-care and task execution abilities among older patients with chronic heart failure following a nurse-led intervention: A longitudinal mixed-effects analysis.
Article in International journal of nursing studies advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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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