Abstract 10786: Teach-Back is an Effective Strategy for Educating Older Heart Failure Patients
Teach-back is endorsed by organizations such as the IHI as an effective method for confirming understanding of health care information in heart failure (HF) patients. Despite this endorsement, no study has demonstrated the effectiveness of teach-back for learning in HF patients.
Aim: To determine whether older hospitalized HF patients educated with the teach-back method can learn and retain self-care information following hospital discharge.
Methods: Self-care was taught to hospitalized HF patients >64 years using the teach-back method. Self-care topics included: high salt foods, when to call the MD, when to report weight gain, and diuretics. One teach-back question for each topic was developed. Successful learning was assessed in patients while hospitalized and 6-8 days after hospitalization.
Results: Subjects' (N=276) mean age was 80 + 9 and 55% (n=153) were female. Within 30 days of hospital discharge 41 (14.9%) patients were readmitted and 52 (19%) died within 12 months. Prior to hospitalization, 86 (31%) were independent with their activities of daily living. Following education using teach-back principles, 233 (84%) patients correctly answered 3 out of 4 (75%) of the teach-back questions. Upon follow-up at 6-8 days, 145 (77%) patients correctly answered 75% of the teach-back questions. Correctly versus incorrectly answered questions were associated with longer teaching times (36 vs 27 minutes, p<.001). Patients who were discharged to a skilled nursing facility answered fewer questions correctly (p=.005). The most often correctly answered question while hospitalized and after discharge related to high salt foods (98%). The most often incorrectly answered question was when to report weight gain (75%). Weight gain was also associated with significant loss of knowledge (p=.001) after hospitalization.
Conclusion: Teach-back was a remarkably effective method to assess and teach self-care in hospitalized HF patients, despite patients' older age and lack of independence. However, effective teaching requires adequate and dedicated time for teaching. Teaching focused on when to report weight gain was more often needed than teaching focused on high salt foods. Future research linking teach-back, self-care and readmissions is needed.
- © 2011 by American Heart Association, Inc.