Assessing nurses’ level of knowledge regarding heart failure self-care education principles in a tertiary cardiology centre in Malaysia

Heart failure (HF) is an alarming global public health issue as the prevalence is increasing, associated with high morbidity, mortality, and rehospitalisation rates. Patient education on self-care is a crucial component of HF management to improve patient outcomes and prevent readmission. Nurses need to equip themselves with adequate knowledge of HF self-care education during patient education sessions. This study aimed to explore the nurses’ knowledge regarding HF self-care education principles and factors associated with their knowledge. A cross-sectional design with a convenience sampling method was used to approach 78 nurses working in the cardiology department of a tertiary cardiology centre in Malaysia. An online questionnaire with the content of social-demographic characteristics and the Nurses’ Knowledge of Heart Failure Educational Principles Survey (NKHFEP) was utilised to explore the nurses’ knowledge score and the social demographic factors associated with their knowledge score. Data were analysed descriptively and inferentially with SPSS version 26 software. The majority of the respondents were at the age of 20-30 (48.7%), had not attended post basic cardiac nursing course (60.3%), worked in a cardiology ward (46.2%), had working experience of 1-5 years in cardiology department (51.3%), not been attend to heart failure certificate course (85.9%), and the source of HF knowledge was from experience in taking care HF patient (76.9%). The respondents’ overall mean±SD score of knowledge in self-care education was 13.36±2.53. Principle topics that scored the least were exercise, followed by sign and symptom management. A significant difference (p<0.05) in the mean overall knowledge score among the nurses working in the Coronary Critical Unit (CCU) (14.38±2.31) and Cardiac High Dependency Ward (CHDW) (14.14±2.22) with nurses in the cardiology ward (12.31±2.46) was found. Nurses with over 31 years and more than six years of working experience in the cardiology department had significantly better knowledge scores in signs and symptoms management topics, with mean±SD of 4.25±1.30 and 4.29±1.25, respectively. Nurses who had not attended the HF certificate course had significantly higher mean knowledge scores than those who had participated in the course (13.61±2.44 vs 11.82±2.64, p<0.05). Knowledge obtained from continuous nursing education (CNE) was significantly increased the nurses’ mean knowledge score in fluid and weight topics (5.75±1.07 vs 4.53±1.58) but vice versa in sign and symptom management topics (3.40±1.27 vs 4.12±1.29). Nurses that worked in different cardiology units was the influencing factor in their knowledge of HF self-care education. Nurses in this study had an overall lower mean knowledge score than nurses in other countries. Besides the sign and symptom topics, nurses in this study showed a lack of understanding of the exercise topic; they misconstrued that HF patients should avoid exercise and restrict activity. A more comprehensive HF specialised course should be implemented, and CNE topics should be focused on exercise and sign and symptom management topics. Nurses could rotate to work in different cardiology units to understand HF management better.

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