Abstract Body (Do not enter title and authors here): Background: Patients with heart failure may suffer from symptom distress, affecting their overall quality of life and psychological well-being including depression. Limited researches focused on the effects of intervention on symptoms and psychological distress for patients with heart failure.
Research Hypothesis: Nutritional education and exercise intervention can significantly improve symptoms and psychological distress in patients with heart failure.
Aims: To investigate the effectiveness of the Nutrition Instruction Combined Exercise and Support program (NICE-Support) on symptom and psychological distress in patients with heart failure.
Methods: This randomized controlled trial recruited 240 patients with heart failure from two medical centers in Taiwan by convenience sampling. Participants were divided into two subgroups based on participation in the "Post-Acute Care Integration Program (PAC)." Each group was randomly assigned to the experimental group and control group, including PAC, PAC+NICE, N-PAC, and N-PAC+NICE groups. The experimental group received a 12-week NICE-Support intervention, encompassing nursing instruction, nutritional counseling, exercise, and support. The control group followed routine hospital care. Data were collected through a structured questionnaire, including basic information, the Heart Failure Symptom Distress Scale, Hospital Anxiety and Depression Scale at baseline, 4, 12, and 24 weeks after enrollment. Data were analyzed using SPSS 24, including descriptive, t-tests, one-way ANOVA, Pearson correlation coefficients, chi-square tests, and generalized estimating equations.
Results: The overall symptom distress score was 45.02 (SD = 13.50). Anxiety and depression were reported in 23.8% and 30.9% patients, with the mean anxiety and depression score of 5.01 (SD = 4.50) and 5.98 (SD = 4.16), respectively. Compared with the N-PAC control group, the PAC+NICE group and N-PAC+NICE group exhibited significant greater improvements in symptom distress at 4, 12, and 24 weeks post-intervention, while the N-PAC+NICE group showed statistically significant greater improvement in anxiety at 12 and 24 weeks.
Conclusion: The NICE-Support program effectively improves symptom and psychological distress in patients with heart failure and could implement in patients with heart failure.