Please use this identifier to cite or link to this item:
Title: Patients' experiences of a nurse-led, home-based heart failure self-management program: Findings from a qualitative process evaluation
Authors: Jiang, Ying 
Koh, Karen Wei Ling
Ramachandran, Hadassah Joann
Tay, Yee Kian
Wu, Vivien Xi 
Shorey, Shefaly 
Wang, Wenru 
Keywords: Heart failure
Mobile phone
Process evaluation
Psychosocial educational
Issue Date: 27-Apr-2021
Publisher: JMIR Publications Inc.
Citation: Jiang, Ying, Koh, Karen Wei Ling, Ramachandran, Hadassah Joann, Tay, Yee Kian, Wu, Vivien Xi, Shorey, Shefaly, Wang, Wenru (2021-04-27). Patients' experiences of a nurse-led, home-based heart failure self-management program: Findings from a qualitative process evaluation. Journal of Medical Internet Research 23 (4) : e28216. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: 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. © Ying Jiang, Karen Wei Ling Koh, Hadassah Joann Ramachandran, Yee Kian Tay, Vivien Xi Wu, Shefaly Shorey, Wenru Wang. Originally published in the Journal of Medical Internet Research (, 27.04.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on, as well as this copyright and license information must be included.
Source Title: Journal of Medical Internet Research
ISSN: 1438-8871
DOI: 10.2196/28216
Rights: Attribution 4.0 International
Appears in Collections:Elements
Staff Publications

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
10_2196_28216.pdf137.95 kBAdobe PDF



Google ScholarTM



This item is licensed under a Creative Commons License Creative Commons