From Education to Impact: Nursing-Led Approaches a Transformative Force in Advanced Valvular Heart Diseases
DOI:
https://doi.org/10.31674/mjn.2026.v18i02.005Abstract
Background: Valvular heart diseases have a substantial impact on healthcare systems, contributing significantly to cardiovascular morbidity and mortality worldwide. Skilled nurses play a crucial role in improving and stabilizing patients’ health and functional status through basic management and follow-up. Objectives: This study aimed to evaluate the efficacy of a structured nursing-led health education program in improving heart failure–related clinical status, health-related quality of life, and medication adherence as well as reducing mortality among patients with advanced valvular heart disease at the Cardiovascular Medicine Departments, Assiut University Heart Hospital, Egypt. Methods: a quasi-experimental research design was used. A purposive sample of 210 patients with advanced valvular heart disease was selected from the cardiovascular medicine departments at Assiut University Heart Hospital, Assiut, Egypt (105 were assigned to the study group and 105 to the control group). Tools: Data were collected using three tools: (I) a patient assessment sheet, (II) a heart quality of life questionnaire, and (III) a Modified Six-Item Morisky Medication Adherence Scale. Results: reveals that 57.1% for the studied & 53.3% for the control groups were aged 50 ≤ 65 years, 50.5% & 62.9% were males, and also statistically significant differences were observed in heart failure assessment, total category of heart QoL, and medication adherence between the study and control groups at six months, which persisted throughout the one-year follow-up period after implementing the nursing-led health education approaches (p-value < 0.001), with moderate effect size. Conclusion: The study's findings demonstrated favorable outcomes, associated with the nursing-led health education approaches. Thus, integrating these approaches into the management of patients with advanced valvular heart disease is strongly recommended to achieve sustained improvements in patient outcomes.
Keywords:
Advanced Valvular Heart Diseases, Nursing-Led Approaches, Quality of lifeDownloads
References
Bernal, J. V., Martínez-Soler, F., Berga Congost, G., Martínez Pérez, J., Asmarats, L., & Moreno Arroyo, C. (2023). Impact of a program of cardiovascular nurse interventions in a valvular haemodynamic unit (PROCESS-VALVE) on quality indicators: A quasi-experimental ambispective study. International Journal of General Medicine, 16, 4257–4265. https://doi.org/10.2147/IJGM.S412369
Chyead, G. J., & Haloob, H. M. (2025). Effectiveness of nursing instructional program on medication adherence for patients with heart failure. The Malaysian Journal of Nursing, 16(3), 77–87. https://doi.org/10.31674/mjn.2025.v16i03.008
Correra, A., Mauriello, A., Del Giudice, C., Fonderico, C., Di Peppo, M., Russo, V., D'Andrea, A., Esposito, G., & Brunetti, N. D. (2026). The incremental role of stress echocardiography in valvular heart disease: A narrative review. Diagnostics, 16(1). https://doi.org/10.3390/diagnostics16010148
Debski, M., Tsampasian, V., Zacharias, J., Ring, L., & Vassiliou, V. S. (2026). ACC/AHA vs ESC/EACTS guidelines on valvular heart disease: EJPC guideline comparison review. European Journal of Preventive Cardiology. zwag015. 1-10. https://doi.org/10.1093/eurjpc/zwag015
Dollaku, H., Buccione, E., Rollo, R., Giuliano, M., Ferri, N., Grifoni, C., & Magi, C. E. (2025). Self-care interventions in valvular heart disease improve important patient outcomes: Results from a systematic review. European Heart Journal, 46(Supplement 1), ehaf784.2430. https://doi.org/10.1093/eurheartj/ehaf784.2430
Duan, Z., Ye, Y., Li, Z., Zhang, B., Liu, Q., Zhao, Z., & CHINA-VHD Collaborators. (2024). Contemporary spectrum, characteristics, and outcomes of adult patients with rheumatic valvular disease in China: Insights from the China-VHD study. International Journal of Cardiology Cardiovascular Risk and Prevention, 21, 200259. https://doi.org/10.1016/j.ijcrp.2024.200259
Fan, Q., Chen, H., Huang, B., & Zhang, X. (2025). Effect of "one disease, one product" combined with self-efficacy nursing on cardiac function and quality of life in patients undergoing rheumatic heart valve replacement. Medicine, 104(31), e43450. https://doi.org/10.1097/MD.0000000000043450
Federal Ministry of Health. (2020). Heart valve disease. Gesund.bund.de. https://gesund.bund.de/ar/herzklappenerkrankung
Grave, C., Gabet, A., Tribouilloy, C., Cohen, A., Lailler, G., Weill, A., & Olié, V. (2024). Epidemiology of valvular heart disease in France. Archives of Cardiovascular Diseases, 117(12), 669–681. https://doi.org/10.1016/j.acvd.2024.10.324
Hassanin, A., Hassanein, M., Bendary, A., & Maksoud, M. A. (2020). Demographics, clinical characteristics, and outcomes among hospitalized heart failure patients across different regions of Egypt. The Egyptian Heart Journal, 72, 49. https://doi.org/10.1186/s43044-020-00082-0
Kasprzak, J. D. (2026). Progression of valvular heart disease: An academic concept or a clinical imperative? Heart, 112(12). https://doi.org/10.1136/heartjnl-2025-327550
Kotit, S., & Yacoub, M. H. (2023). The Aswan Rheumatic heart disease reGIstry: Rationale and preliminary results of the ARGI database. Frontiers in Cardiovascular Medicine, 10, 1230965. https://doi.org/10.3389/fcvm.2023.1230965
Lakens, D. (2022). Sample size justification. Collabra: Psychology, 8(1), 33267. https://doi.org/10.1525/collabra.33267
Li, D., Liu, P., Zhang, H., & Wang, L. (2021). The effect of phased written health education combined with healthy diet on the quality of life of patients after heart valve replacement. Journal of Cardiothoracic Surgery, 16, 183. https://doi.org/10.1186/s13019-021-01437-7
Majrashi, H. M., Khwaji, F. Z., Khalf AlNomsi, A., Alenazi, B. O., Qaisi, N. A., Nasser, S. M., & Alzahrani, A. Y. (2024). The critical role of nurses in managing patients with valvular heart disease. Journal of International Crisis and Risk Communication Research, 7(S8), 1–12. https://doi.org/10.63278/jicrcr.vi.1103
Mohebbi, B., Sabouri, M., & Tol, A. (2021). Application of health education and promotion theory-based interventions on patients with cardiovascular disease: A systematic review. Journal of Education and Health Promotion, 10(1), 1–7. https://doi.org/10.4103/jehp.jehp_221_21
Morisky, D. E., Green, L. W., & Levine, D. M. (1986). Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care, 24(1), 67–74. https://doi.org/10.1097/00005650-198601000-00007
Oktarina, Y., Nurhusna, N., Sari, Y. I. P., Rudini, D., & Subandi, A. (2025). Improving cardiovascular health index: The effect of education intervention program in coronary artery disease patients. The Malaysian Journal of Nursing, 17(2), 68–80. https://doi.org/10.31674/mjn.2025.v17i02.007
Oldridge, N., Höfer, S., McGee, H., Conroy, R., Doyle, F., Saner, H., & HeartQoL Project Investigators. (2014). The HeartQoL: Part I. Development of a new core health-related quality of life questionnaire for patients with ischemic heart disease. European Journal of Preventive Cardiology, 21(1), 90–97. https://doi.org/10.1177/2047487312450544
Pang, L., Xia, Y., Tang, M., Ma, M., Ran, H., Zhao, Z., & Zhu, D. (2025). Prevalence, spectrum and aetiology of valvular heart disease based on community echocardiographic screening transition from different altitudes in Yunnan, China. Heart, 111(22), 1084–1090. https://doi.org/10.1136/heartjnl-2024-325221
Qiu, X. (2024). Nurse-led intervention in the management of patients with cardiovascular diseases: A brief literature review. BMC Nursing, 23, Article 6. https://doi.org/10.1186/s12912-023-01422-6
Salehi, N., Heydarpour, P., Salimi, Y., Ziapour, A., Majzoobi, M. R., Geravand, S., & Janjani, P. (2024). Comparison of quality of life in patients with mitral valve replacement and mitral valve repair in Imam Ali Hospital during 2014 to 2020: A cross-sectional study. Journal of Cardiothoracic Surgery, 19(1), 1–8. https://doi.org/10.1186/s13019-024-02780-1
Sherif, A. S. E. H., Mohamed, M. G., Ahmeedah, I. S. H., & Abdelbasit, M. S. (2025). Rheumatic heart disease: Pathophysiology and management. Zagazig University Medical Journal, 31(1), 135–142. https://doi.org/10.21608/zumj.2024.326657.3623
Vesvrotte, E. R., Afana, A. S., Florence, J., Unger, A., Gall, E., Toupin, S., & Pezel, T. (2025). Multiple and mixed valvular heart disease: State-of-the-art. Journal of the Heart Valve Society, 2(2), 254–276. https://doi.org/10.1177/30494826251330128
Wang, Y., Cao, T., Liu, X., He, S., Ran, Z., Du, C., & Guo, Y. (2025). A new benchmark for modern management of valvular heart disease: The whole-life cycle management system. JACC: Asia, 5(5), 609–632. https://doi.org/10.1016/j.jacasi.2025.01.017
Wongpiriyayothar, A., Ruangchaithaweesuk, K., & Thanoochan, R. (2024). The effects of an educational program for heart failure prevention using telephone monitoring on symptoms and quality of life among patients with valvular heart disease. Nursing Journal CMU, 51(1), 29–43. https://he02.tci-thaijo.org/index.php/cmunursing/article/view/265023
Yakob, T., Belay, E., Barata, B. Y., Abraham, A., Assele, D. D., & Israel, E. (2025). Valvular heart disease and associated factors among adult cardiac patients in a tertiary hospital, Ethiopia. BMC Cardiovascular Disorders, 25, 502. https://doi.org/10.1186/s12872-025-04958-4
Zhang, S., Liu, C., Wu, P., Li, H., Zhang, Y., Feng, K., & Zhan, J. (2024). Burden and temporal trends of valvular heart disease-related heart failure from 1990 to 2019 and projection up to 2030 in Group of 20 countries: An analysis for the Global Burden of Disease Study 2019. Journal of the American Heart Association, 13(20), e036462. https://doi.org/10.1161/JAHA.124.036462
Zhou, J., Zhou, Y., Huang, Y., & Wang, P. (2025). Nurse-led cardiac rehabilitation programme on physical capacity and mental health for heart valve patients: Study protocol of a quasi-experimental study. BMJ Open, 15(9), e096823. https://doi.org/10.1136/bmjopen-2024-096823
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