Efetividade de intervenção educativa no prognóstico de pacientes com insuficiência cardíaca: ensaio clínico randomizado

Abstract

Introduction: Heart failure (HF) is a chronic condition associated with high morbidity and mortality, as well as frequent rehospitalizations in Brazil. Educational strategies led by nurses have shown promise in enhancing self-care and improving prognosis. Objective: To evaluate the effectiveness of a nursing educational intervention in patients with HF followed in hospitals in the state of Sergipe. Methods: A multicenter, randomized clinical trial conducted in six public hospitals in Sergipe. Adult patients with confirmed HF who were clinically stable at hospital discharge were included. Randomization allocated 120 participants; however, due to loss to follow-up, the final sample consisted of an intervention group (IG, n = 49) and a control group (CG, n = 56). The outcomes evaluated were: clinical congestion, NT-proBNP levels, and quality of life (Minnesota Living with Heart Failure Questionnaire). Results: The results showed no statistically significant differences between groups regarding clinical congestion (p = 0.178) and NT-proBNP serum levels (p = 0.312). However, the intervention group demonstrated a significant improvement in quality of life, with a mean reduction of 18.7 points in the total score compared to baseline (p < 0.001), while the control group showed a reduction of only 5.4 points (p = 0.084). Improvement was consistent across the physical (p < 0.001), emotional (p = 0.002), and social (p < 0.001) domains. Conclusion: The nursing educational intervention proved effective in improving the quality of life of patients with HF, even in the short term and within a context of social vulnerability. Although no immediate changes in biomarkers or clinical congestion were detected, the results reinforce the relevance of educational strategies as a complementary tool in HF care within the Brazilian public health system (SUS). Key-words: Heart Failure; Nursing; Patient Education; Prognosis.