The effectiveness of telehealth care on caregiver burden, mastery of stress, and family function among family caregivers of heart failure patients: A quasi-experimental study Li-Chi Chiang a , Wan-Chou Chen b , Yu-Tzu Dai b,c , Yi-Lwun Ho d, * a School of Nursing, National Defense Medical Center & China Medical University, Taipei & Taichung, Taiwan b Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan c Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan d Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan International Journal of Nursing Studies 49 (2012) 1230–1242 A R T I C L E I N F O Article history: Received 31 July 2011 Received in revised form 25 April 2012 Accepted 28 April 2012 Keywords: Telehealth Telenursing Discharge planning Family caregiver Heart failure A B S T R A C T Background: Telehealth care was developed to provide home-based monitoring and support for patients with chronic disease. The positive effects on physical outcome have been reported; however, more evidence is required concerning the effects on family caregivers and family function for heart failure patients transitioning from the hospital to home. Objective: To evaluate the effectiveness of nursing-led transitional care combining discharge plans and telehealth care on family caregiver burden, stress mastery and family function in family caregivers of heart failure patients compared to those receiving traditional discharge planning only. Design: This is a quasi-experimental study design. Methods: Sixty-three patients with heart failure were assessed for eligibility and invited to participate in either telehealth care or standard care in a medical centre from May to October 2010. Three families refused to participate in data collection. Thirty families who chose telehealth care after discharge from the hospital to home comprised the experimental group; the others families receiving discharge planning only comprised the comparison group. Telenursing specialist provided the necessary family nursing interventions by 24-h remote monitoring of patients’ health condition and counselling by telephone, helping the family caregivers successfully transition from hospital to home. Data on caregiver burden, stress mastery and family function were collected before discharge from the hospital and one month later at home. Effects of group, time, and group  time interaction were analysed using Mixed Model in SPSS (17.0). Results: Family caregivers in both groups had significantly lower burden, higher stress mastery, and better family function at one-month follow-up compared to before discharge. The total score of caregiver burden, stress mastery and family function was significantly improved for the family caregivers in the experimental group compared to the comparison group at posttest. Two subscales of family function—Relationships between family and subsystems and Relationships between family and society were improved in the experimental group compared to the comparison group, but Relationships between family and family members was not different. * Corresponding author at: NTU Telehealth Center, NTUH East Wing B Block, 3rd Floor, No. 7, Chung-Shan South Road, Taipei 100, Taiwan. Tel.: +886 2 2356 2872; fax: +886 2 2356 2885. E-mail addresses: abundantia0909@gmail.com (W.-C. Chen), yutzu@ntu.edu.tw (Y.-T. Dai), ylho@ntu.edu.tw (Y.-L. Ho). Contents lists available at SciVerse ScienceDirect International Journal of Nursing Studies journal homepage: www.elsevier.com/ijns 0020-7489/$ – see front matter ß 2012 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ijnurstu.2012.04.013