Self-care goals proposition and achievement by patients undergoing oral anticoagulation during an educational intervention based on empowerment

Abstract

Objective: To identify self-care goals proposition and achievement established by patients using warfarin during an educational intervention based on health empowerment in a middle-income country. Methods: Descriptive study with 103 patients of a Teaching Hospital anticoagulation clinic (AC) located in Minas Gerais. The inclusion criteria were age ≥ 18 years, both sexes, use of warfarin > 6 months, diagnosis of valvular or nonvalvular atrial fibrillation (AF), attended to the AC between july and december 2018, low quality oral anticoagulation and participation in the first and/or second circle of culture (CC) of the educational intervention (IE). The exclusion criteria were impossibility of verbal communication, deafness, blindness or health problems that could compromise attendance at the AC. The proposition of goals took place between april and july 2019 during the IE which was composed by four monthly CC with different subjects. Between them, telefone contacts were done using a Behavior Change Protocol validated in Brazil. Sociodemographic variables, general and specific goals and its achievement were considered and the correlation between the number of patients who participated in each CC and biological sex was performed. Descriptive statistical analysis was performed. Results: Patients had a mean age of 64.2 (SD 12.7) years, with a predominance of females (71; 69.6%). Considering the 33 patients who proposed general goals, 60.6% (20) achieved and 80.7% (67) of the 83 patients who answered the phone achieved the specific goals. The most accomplished specific goals (37; 74,0%;) were those about food rich in vitamin K consumption, mentioned a total of 50 times, and the most accomplished general goal (3; 75,0%) referred to other self-care practices, mentioned a total of 4 times. The specific goal that had the highest percentage of non-compliance (60,0%; 6) was related to physical activity, mentioned a total of 10 times, with a statistically significant p value (0.001). Conclusion: The results suggest that educational interventions can contribute to the identification and achievement of self-care goals in patients using warfarin and more robust studies are recommended.