Background: Heart failure (HF) is a major public health problem that places a significant disease burden on society. Self-care is important in the management of HF because it averts disease progression and reduces the number of hospitalizations. Effective nursing interventions promote HF self-care. Objective: This study aims to explore participants’ perspectives on a nurse-led, home-based heart failure self-management program (HOM-HEMP) in a randomized controlled trial conducted in Singapore to gain insight into the effectiveness of the study intervention. Methods: A descriptive, qualitative approach was used. English- or Chinese-speaking participants from the intervention arms were recruited through a purposive sampling method from January 2019 to July 2019. Individual, face-to-face, semistructured interviews were conducted with 11 participants. All interviews were audio recorded and transcribed verbatim, with the participant identifiers omitted to ensure confidentiality. The thematic analysis approach was used to identify, analyze, and report patterns (themes) within the data. Results: A total of six themes emerged from the process evaluation interviews and were categorized according to the Donabedian structure-process-outcome framework as intervention structure, intervention process, and intervention outcome. These six themes were manageability of the intervention, areas for improvement, benefits of visiting, personal accountability in self-care, empowered with knowledge and skills in self-care after the intervention, and increased self-efficacy in cardiac care. Conclusions: The findings of the process evaluation provided additional information on participants’ perceptions and experiences with the HOM-HEMP intervention. Although a home visit may be perceived as resource intensive, it remains to be the preferred way of engagement for most patients. Nurses play an important role in promoting HF self-care. The process of interaction with the patient can be an important process for empowering self-care behavior changes.

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中文翻译：

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护士主导的居家心力衰竭自我管理计划的患者体验：定性过程评估的结果

背景：心力衰竭（HF）是一个主要的公共卫生问题，给社会带来了重大的疾病负担。自我护理在 HF 管理中很重要，因为它可以避免疾病进展并减少住院次数。有效的护理干预促进 HF 自我护理。目标：本研究旨在探讨参与者对在新加坡进行的随机对照试验中护士主导的、以家庭为基础的心力衰竭自我管理计划 (HOM-HEMP) 的看法，以深入了解研究干预的有效性。方法：使用了描述性的、定性的方法。从 2019 年 1 月至 2019 年 7 月，通过有目的的抽样方法从干预组中招募了讲英语或中文的参与者。 对 11 名参与者进行了个人、面对面、半结构化的访谈。所有采访都被录音并逐字转录，为确保机密性，省略了参与者的标识符。主题分析方法用于识别、分析和报告数据中的模式（主题）。结果：过程评估访谈中总共出现了六个主题，并根据多纳比德结构-过程-结果框架将其分类为干预结构、干预过程和干预结果。这六个主题是干预的可管理性、需要改进的领域、探访的好处、自我保健的个人责任感、干预后自我保健的知识和技能以及提高心脏护理的自我效能。结论：过程评估的结果提供了关于参与者对 HOM-HEMP 干预的看法和经验的额外信息。尽管家访可能被认为是资源密集型的，但它仍然是大多数患者的首选参​​与方式。护士在促进 HF 自我护理方面发挥着重要作用。与患者互动的过程可能是促进自我护理行为改变的重要过程。

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