Jaana , Sherrard and Pare ( 2019 ) report that patients find the telemonitoring technology user-friendly . Patients receive support from family members , friends , and nurses on the use of the technology and patients ' desire to use the technology are high ( Jaana et al ., 2019 ). Jaana et al ( 2019 ) did a longitudinal study to measure empowerment , self-care , and adoption factors in elderly patients with CHF . Twentythree patients were included in the study , and the study was for six months . When the sample size of quantitative research is small , it could affect the external validity of the research , and as a result , affect the ability of the findings to be generalised to a larger population ( Barker , Kane & Nelson , 2019 ; Sutherland , 2017 ).
Riley , Gabe , and Cowie ( 2013 ) performed a qualitative study to explore to what degree can telemonitoring empower HF patients to selfcare . The study was for six months , and fifteen patients were included in the study . Semiconstructed interviews were conducted , and the interviews were transcribed and audiotaped . Thematic analysis was used to derive the themes for the study , and it was clear how this occurred . Riley et al ( 2013 ) report that all patients involved in the study engaged with the telemonitoring technology daily . Patients with comorbidities that affect their physical functioning , for example , Parkinson ’ s disease , develop strategies to use the telemonitoring technology , and they have support from their family members as required ( Riley et al ., 2013 ).
HF patients ’ knowledge of their condition
Boyne et al ( 2014 ) report that there is a significant increase in patients ’ knowledge of their condition in the telemonitoring group ( p < 0.001 ) after twelve months . In the usual group , there is an increase in their knowledge level but not a significant increase ( Boyne et al ., 2014 ). Riley et al ( 2013 ) report that patients can develop their knowledge of their HF condition over six months of using telemonitoring .
de Oliveira , Cordeiro , Rocha , Guimaraes and de Albuquerque ( 2017 ) performed an RCT that measured the correlation between knowledge and self-care in HF patients that used telephone-based monitoring , and the study was for four months . The study contained a sample size of thirty-six patients who were randomised into two groups : nineteen patients in the intervention group and seventeen patients in the control group . In the intervention group , there is a significant increase in patients ’ knowledge in the second and fourth month ( p = 0.001 ). In the control group , there is an increase in patients ’ knowledge in the second month , but the increase is not maintained in the fourth month , and no explanation is offered by the researchers on this ( de Oliveira et al ., 2017 ). The CONSORT 2010 checklist was used ; however , the CONSORT flow chart was not used . The CONSORT statement consists of the CONSORT checklist and the flow diagram ( Aveyard , 2019 ). The CONSORT statement guides researchers to report RCTs thoroughly and transparently ( Schulz , Altman & Moher , 2011 ).
Fairbrother et al ( 2014 ) report that patients observed an improvement in their knowledge and understanding of their condition by using telemonitoring . Jaana et al ( 2019 ) find that after three months of using telemonitoring , patients ’ knowledge of their condition slightly increased . Surprisingly , this increase is not maintained in the sixth month ( Jaana et al ., 2019 ). Interestingly , de Oliveira et al ( 2017 ) observe that there is a significant negative correlation between self-care and knowledge in the intervention group in the 2nd month ( r = -0.48 , p = 0.03 ). This suggests that as patients ’ self-care skills increases , patients ' knowledge of their condition will decrease and vice versa . This negative correlation is maintained in the 4th month ( r = -0.37 , p = 0.11 ). These findings are worthy of consideration when designing an improvement tool to meet the needs of this patient group .
Self-care in HF patients
This theme aims to critically analyse the effect of telemonitoring on self-care in HF patients . The term self-care consists of two components : selfcare maintenance and self-care management ( Riegel , Lee , Dickson & Carlson , 2009 ; Riegel ,
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