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Psychometric Characteristics of the Caregiver Contribution to Self-care of Heart Failure Index in a South American Population. J Cardiovasc Nurs 2021; 35:435-444. [PMID: 32511111 DOI: 10.1097/jcn.0000000000000704] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Caregivers can contribute enormously to the self-care of patients with heart failure (HF). The Caregiver Contribution to Self-care of Heart Failure Index (CC-SCHFI) measures these contributions across 3 scales: self-care maintenance, which evaluates caregiver contributions to symptom monitoring and treatment adherence; self-care management, which evaluates caregiver contributions in dealing with symptoms; and caregiver confidence, which assesses caregiver self-efficacy in managing all contributions to self-care. Although the CC-SCHFI has been used in several investigations, only 1 study has evaluated its psychometric characteristics. OBJECTIVE The aim of this study was to evaluate the psychometric properties of the CC-SCHFI in Brazil. METHODS A cross-sectional design was used in this study. Confirmatory factor analysis was used to assess construct validity, and factor score determinacy coefficients were computed to evaluate internal consistency reliability. RESULTS The sample comprised 99 caregivers of patients with HF. Most were women (73%), with a mean age of 48 ± 14 years; 57% were patients' spouses. Confirmatory factor analysis confirmed the original factor structure of the instrument, with supportive fit indices for all 3 scales (comparative fit index, 0.95-1.00; root-mean-square error of approximation, 0.00-0.057). Reliability estimates were adequate for each CC-SCHFI scale (0.77-0.96). CONCLUSIONS The CC-SCHFI is a valid and reliable scale to measure caregiver contributions to self-care maintenance, caregiver contributions to self-care management, and caregiver confidence in HF.
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De Maria M, Iovino P, Lorini S, Ausili D, Matarese M, Vellone E. Development and Psychometric Testing of the Caregiver Self-Efficacy in Contributing to Patient Self-Care Scale. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1407-1415. [PMID: 34593163 DOI: 10.1016/j.jval.2021.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 05/28/2023]
Abstract
OBJECTIVES Caregiver self-efficacy-a caregiver's belief in his/her ability to contribute to patient self-care-is associated with better patient and caregiver outcomes in single chronic conditions. It is, however, unknown if caregiver self-efficacy improves patient and caregiver outcomes in multiple chronic conditions (MCCs) because there is no instrument to measure this variable. We developed the 10-item Caregiver Self-Efficacy in Contributing to patient Self-Care (CSE-CSC) scale for that purpose, and we tested its psychometric characteristics in caregivers of patients with MCCs. METHODS In this cross-sectional multisite study, we tested the structural validity of the CSE-CSC scale with exploratory and confirmatory factor analysis, and we tested construct validity by correlating CSE-CSC scores with those of the Caregiver Contributions to Self-Care of Chronic Illness Inventory. We also tested reliability, and precision of the CSE-CSC scale. RESULTS The 358 enrolled caregivers (mean age 54.6 years; 71.5% female) cared for patients with an average of 3.2 chronic conditions. Structural validity was good, and it showed 2 factors within the scale. Construct validity showed significant correlations between scores of the CSE-CSC scale and the Caregiver Contributions to Self-Care of Chronic Illness Inventory. Reliability coefficients were between 0.90 and 0.97. Measurement error yielded satisfactory results. CONCLUSIONS The CSE-CSC scale is valid, reliable, and precise in measuring caregiver self-efficacy in contributing to patient self-care in MCCs. Because caregiver self-efficacy is a modifiable variable, the CSE-CSC scale can be used in clinical practice and research to improve patient and caregiver outcomes.
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Affiliation(s)
- Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Silvia Lorini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Maria Matarese
- Research Unit of Nursing Science, Campus Bio-medico University of Rome, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Matarese M, Pendoni R, Piredda M, De Marinis MG. Caregivers' experiences of contributing to patients' self-care in Chronic Obstructive Pulmonary Disease: A thematic synthesis of qualitative studies. J Adv Nurs 2021; 77:4017-4034. [PMID: 34245173 PMCID: PMC8518034 DOI: 10.1111/jan.14942] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/21/2021] [Accepted: 06/15/2021] [Indexed: 02/03/2023]
Abstract
AIM To identify, analyze and synthesize qualitative studies on caregivers' experiences of contributions to the self-care of patients with Chronic Obstructive Pulmonary Disease (COPD). BACKGROUND COPD patients perform daily self-care behaviours to manage the disease. With aging and disease progression, patients need to rely on the contributions of informal caregivers, usually family members, for disease management. Caregivers' normal or habitual contributions to patients' self-care have not yet been completely investigated. DESIGN Thematic synthesis of qualitative studies. DATA SOURCES CINAHL, EMBASE, PubMed, PsycINFO, Web of Science, Scopus, Emcare and OpenGrey databases were searched from inception to September 2020. The search was restricted to English-language papers. REVIEW METHODS Studies were critically appraised using the Critical Appraisal Skills Programme checklist. The initial line-by-line codes were aggregated into descriptive themes from which analytical themes were derived. RESULTS Fifteen papers from nine countries, published 2009-2020, were included. Six analytical themes encompassing 22 descriptive themes were identified and grouped in two overarching themes describing caregivers' experiences of contributions to patients' self-care during the stable and exacerbation phases of COPD. In the stable phases, caregivers contribute through maintaining disease stability, promoting healthy behaviours, fostering normal life and helping perform daily activities. During exacerbations, caregivers contribute through assessing, monitoring and managing symptoms in collaboration with patients or autonomously. They contribute by performing actions, motivating patients, organizing care, sensing variations in symptoms, acquiring knowledge and educating patients, making decisions, communicating and collaborating with healthcare providers and patients and advocating for patients. CONCLUSION This thematic synthesis enlarges knowledge of caregivers' contributions to patients' self-care in COPD, detailing the ways by which caregivers provide care to patients. IMPACT Contributing daily to the self-care of a family member with COPD is a complex experience. Nurses need to acknowledge the importance of caregivers' contributions to patient disease management and develop effective educational interventions to support them.
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Affiliation(s)
- Maria Matarese
- Research Unit of Nursing SciencesCampus Bio‐Medico University of RomeRomeItaly
| | - Roberta Pendoni
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Michela Piredda
- Research Unit of Nursing SciencesCampus Bio‐Medico University of RomeRomeItaly
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Abstract
BACKGROUND Lay caregivers are important in contributing to self-care of patients with heart failure (HF). The Caregiver Contributions to Self-Care of Heart Failure Index (CC-SCHFI) measures these contributions, but after developing the Situation-Specific Theory of Caregiver Contributions to Heart Failure Self-Care, the CC-SCHFI needed updating to reflect the theory. OBJECTIVE The aim of this study was to test the psychometric characteristics of the CC-SCHFI 2 that measures caregiver contributions (CC) to HF self-care with 3 scales: CC to self-care maintenance, CC to symptom perception, and CC to self-care management. METHODS This is a cross-sectional study. We tested the CC-SCHFI 2 with confirmatory factor analysis, internal consistency, item-total correlations, and test-retest reliability. With the CC-SCHFI 2, we also administered the Self-Care of Heart Failure Index v.7.2 to patients and the Caregiver Contribution to Heart Failure Self-Care Scale to caregivers to assess concurrent validity. RESULTS A sample of 277 caregivers was enrolled (mean [SD] age, 52.7 [14.9] years; 70.4% female). In confirmatory factor analysis, each CC-SCHFI 2 scale had supportive fit indices: comparative fit index ranged between 0.94 and 0.95, and root mean square error of approximation ranged between 0.05 and 0.07. Internal consistency of the 3 scales was evident with a Cronbach α between .81 and .83 and a global reliability index between 0.79 and 0.86. Item-total correlations were all greater than 0.30. In concurrent validity testing, there were significant correlations between the CC-SCHFI 2 and the Self-Care of Heart Failure Index v.7.2 and the Caregiver Contribution to Heart Failure Self-Care Scale. Test-retest reliability showed intraclass correlation coefficients between 0.72 and 0.91. CONCLUSIONS Testing of the CC-SCHFI 2 supported validity and reliability, indicating that the instrument can be used in clinical practice and research to evaluate CC to the self-care of patients with HF.
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The Influence of Caregiver Preparedness on Caregiver Contributions to Self-care in Heart Failure and the Mediating Role of Caregiver Confidence. J Cardiovasc Nurs 2021; 35:243-252. [PMID: 32084078 DOI: 10.1097/jcn.0000000000000632] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Caregiver contributions (CC) to heart failure (HF) self-care maintenance (ie, CC to maintaining HF stability) and management (ie, CC to dealing with HF signs and symptoms) improve patient outcomes, but it is unknown whether caregiver preparedness influences CC to self-care and whether caregiver confidence mediates this process. OBJECTIVES We evaluated the influence of caregiver preparedness on CC to HF self-care maintenance and management and the mediating role of caregiver confidence. METHODS This is a secondary analysis of the MOTIVATE-HF study. Patients were 18 years or older, with a diagnosis of HF in New York Heart Association classes II to IV, who had insufficient self-care and did not have severe cognitive impairment. Patients' informal caregivers were those people inside or outside the family who gave most of the informal care to the patients. We used the Caregiver Preparedness Scale and the Caregiver Contribution to Self-Care of HF Index. We tested a path analysis model and the indirect effects. RESULTS Caregivers (n = 323) were 55 (SD, 15) years old on average and predominantly female (77%). The path analysis showed that higher scores in caregiver preparedness were associated with higher scores in caregiver confidence. In turn, higher caregiver confidence was associated with higher CC to self-care maintenance and management. Caregiver confidence mediated the association between caregiver preparedness and CC to self-care maintenance and management. CONCLUSIONS Caregiver confidence may play a role in CC to self-care. Interventions to improve CC to HF self-care should not only be focused on improving caregiver preparedness but also should consider the role of caregiver confidence.
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Self-care in spinal cord injuries inventory (SC-SCII) and self-care self-efficacy scale in spinal cord injuries (SCSES-SCI): development and psychometric properties. Spinal Cord 2021; 59:1240-1246. [PMID: 34455422 DOI: 10.1038/s41393-021-00702-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Validation cross-sectional study. OBJECTIVES To develop and assess the psychometric properties of two instruments based on the middle-range theory of self-care in chronic illness: the Self-Care in Spinal Cord Injuries Inventory (SC-SCII) and the Self-Care Self-Efficacy Scale in Spinal Cord Injuries (SCSES-SCI). SETTING Multicenter study in five spinal units across Italy and Ireland. METHODS Instrument development was based on self-care behaviours identified in the scientific literature. Behaviours were grouped into four dimensions during a consensus conference: self-care maintenance, self-care monitoring, self-care management and self-care self-efficacy. Sixty-seven items were subsequently generated based on these dimensions. A multidisciplinary group of 40 experts evaluated content validity. Dimensionality of the final items was tested by confirmatory factor analyses (CFA) with a sample of 318 participants. Internal consistency and test-retest reliability were evaluated for each dimension. Construct validity was assessed using correlations between items and scoring differences amongst participants with more severe conditions and secondary complications. RESULTS Content validity of the SC-SCII and SCSES-SCI was satisfactory for thirty-five of the previously generated items, which were further refined. CFA showed comparative fit indexes ranging from 0.94 to 0.97 and root mean square errors of approximation from 0.03 to 0.07. Internal consistency ranged from 0.71 to 0.85, and intraclass correlation coefficients were higher than 0.70. Correlations among dimensions were moderate, and the theoretical hypotheses formulated when designing the instruments were largely confirmed. CONCLUSIONS The SC-SCII and the SCSES-SCI represent valid and reliable theoretically-grounded instruments to assess self-care in people with spinal cord injury.
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Santos GC, Liljeroos M, Hullin R, Denhaerynck K, Wicht J, Jurgens CY, Schäfer-Keller P. SYMPERHEART: an intervention to support symptom perception in persons with heart failure and their informal caregiver: a feasibility quasi-experimental study protocol. BMJ Open 2021; 11:e052208. [PMID: 34315799 PMCID: PMC8317123 DOI: 10.1136/bmjopen-2021-052208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Symptom perception in heart failure (HF) has been identified as crucial for effective self-care, and is related to patient and health system outcomes. There is uncertainty regarding the feasibility and acceptability of symptom perception support and doubts regarding how to include informal caregivers. This study aims to test the feasibility, acceptability and outcome responsiveness of an intervention supporting symptom perception in persons with HF and their informal caregiver. METHODS AND ANALYSIS A feasibility study with a quasi-experimental pretest and post-test single group design is conducted. The convenience sample consists of 30 persons with HF, their informal caregivers and six nurses. SYMPERHEART is an evidence-informed intervention that targets symptom perception by educational and support components. Feasibility is measured by time-to-recruit; time-to-deliver; eligibility rate; intervention delivery fidelity rate. Acceptability is measured by rate of consent, retention rate, treatment acceptability and the engagement in the intervention components. Outcome responsiveness includes: HF self-care (via the Self-care of Heart Failure Index V.7.2); perception of HF symptom burden (via the Heart Failure Somatic Perception Scale V.3); health status (via the Kansas City Cardiomyopathy Questionnaire-12); caregivers' contribution to HF self-care (via the Caregiver Contribution to Self-Care of Heart Failure Index 2); caregivers' burden (via the Zarit Burden Interview). Clinical outcomes include HF events, hospitalisation reason and length of hospital stay. Descriptive statistics will be used to report feasibility, acceptability, patient-reported outcomes (PRO) and clinical outcomes. PRO and caregiver-reported outcome responsiveness will be reported with mean absolute change and effect sizes. ETHICS AND DISSEMINATION The study is conducted according to the Declaration of Helsinki. The Human Research Ethics Committee of the Canton of Vaud, Switzerland, has approved the study. Written informed consent from persons with HF and informal caregivers are obtained. Results will be published via peer reviewed and professional journals, and further disseminated via congresses. TRIAL REGISTRATION NUMBER ISRCTN18151041.
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Affiliation(s)
- Gabrielle Cécile Santos
- School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
- Institute of Higher Education and Research in Healthcare, University of Lausanne Faculty of Biology and Medicine, Lausanne, Switzerland
| | - Maria Liljeroos
- Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Roger Hullin
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Kris Denhaerynck
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland
| | - Justine Wicht
- Service d'Aide et de Soins à Domicile de la Sarine, Fribourg, Switzerland
| | - Corrine Y Jurgens
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Petra Schäfer-Keller
- School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
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Giordano V, Iovino P, Corvese F, Vellone E, Alvaro R, Villa G. Caregiver contribution to self-care and its associated variables among caregivers of ostomy patients: Results of a cross-sectional study. J Clin Nurs 2021; 31:99-110. [PMID: 34121255 DOI: 10.1111/jocn.15851] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/02/2021] [Accepted: 04/23/2021] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To describe caregiver contribution (CC) to ostomy self-care and identify its associated variables among caregivers of ostomy patients. BACKGROUND Self-care is essential for ostomy patients, but it can be difficult to perform. In these cases, caregivers play a key role in promoting self-care behaviours. So far, the CC to ostomy self-care has not been investigated thoroughly. DESIGN This is a cross-sectional and multicentre study conducted at seven outpatient clinics of two Italian regions. METHODS We recruited 252 caregivers between February 2017-May 2018. The Caregiver Contribution to Ostomy Self-Care Index (CC-OSCI) was used to measure CC to ostomy self-care. Three multivariable linear regression models were fitted to identify variables associated with CC dimensions (maintenance, monitoring and management). The STROBE checklist was used to report the present study. RESULTS The sample (mean age = 58.73, SD = 13.98) was mostly female (80.60%), unemployed (58.70%) and resided with the patient (81.00%). Caregivers being employed and those declaring more hours of contribution per week were associated with a significantly lower contribution to self-care maintenance. Caregivers with lower levels of education and those residing with the patient were less likely to contribute to CC to self-care monitoring. Spousal caregivers and those with higher preparedness contributed significantly lower to CC to self-care management. CONCLUSIONS We found a variety of sociodemographic factors associated with CC to ostomy self-care. RELEVANCE TO CLINICAL PRACTICE Sociodemographic variables associated with CC to ostomy self-care can help clinicians develop more tailored educational interventions for caregivers who find their contribution challenging.
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Affiliation(s)
- Vittoria Giordano
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,School of Nursing, Midwifery and Paramedicine Faculty of Health Science, Australian Catholic University, Melbourne, Australia
| | - Francesco Corvese
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy
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Dall’Oglio I, Gasperini G, Carlin C, Biagioli V, Gawronski O, Spitaletta G, Grimaldi Capitello T, Salata M, Vanzi V, Rocco G, Tiozzo E, Vellone E, Raponi M. Self-Care in Pediatric Patients with Chronic Conditions: A Systematic Review of Theoretical Models. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3513. [PMID: 33800684 PMCID: PMC8037526 DOI: 10.3390/ijerph18073513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/13/2021] [Accepted: 03/24/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND To improve outcomes in children and young adults (CYAs) with chronic conditions, it is important to promote self-care through education and support. AIMS (1) to retrieve the literature describing theories or conceptual models of self-care in CYAs with chronic conditions and (2) to develop a comprehensive framework. METHODS A systematic literature search was conducted on nine databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All peer-reviewed papers describing a theory or a conceptual model of self-care in CYAs (0-24 years) with chronic conditions were included. RESULTS Of 2674 records, 17 met the inclusion criteria. Six papers included a theory or a model of self-care, self-management, or a similar concept. Six papers developed or revised pre-existing models or theories, while five papers did not directly focus on a specific model or a theory. Patients were CYAs, mainly with type 1 diabetes mellitus and asthma. Some relevant findings about self-care in CYAs with neurocognitive impairment and in those living with cancer may have been missed. CONCLUSIONS By aggregating the key elements of the 13 self-care conceptual models identified in the review, we developed a new overarching model emphasizing the shift of self-care agency from family to patients as main actors of their self-management process. The model describes influencing factors, self-care behaviors, and outcomes; the more patients engaged in self-care behaviors, the more the outcomes were favorable.
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Affiliation(s)
- Immacolata Dall’Oglio
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Giulia Gasperini
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Claudia Carlin
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Valentina Biagioli
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Orsola Gawronski
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Giuseppina Spitaletta
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Teresa Grimaldi Capitello
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Michele Salata
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Valentina Vanzi
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Gennaro Rocco
- Centre of Excellence for Nursing Scholarship-Nursing Professional Order of Rome, Viale Giulio Cesare, 78, 00192 Rome, Italy;
| | - Emanuela Tiozzo
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Massimiliano Raponi
- Bambino Gesù Children’s Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165 Rome, Italy; (G.G.); (C.C.); (V.B.); (O.G.); (G.S.); (T.G.C.); (M.S.); (V.V.); (E.T.); (M.R.)
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Bugajski A, Buck H, Zeffiro V, Morgan H, Szalacha L, Alvaro R, Vellone E. The influence of dyadic congruence and satisfaction with dyadic type on patient self-care in heart failure. Eur J Cardiovasc Nurs 2021; 20:268–275. [PMID: 33611366 DOI: 10.1177/1474515120960002] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/21/2020] [Accepted: 08/31/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Chronic illness management is increasingly carried out at home by individuals and their informal caregivers (dyads). Although synergistic in concept, the nuances of dyadic congruence in caring for patients with heart failure are largely unexamined. AIMS The purpose of this study was to examine the role of dyadic-type congruence on patient self-care (maintenance, symptom perception, and management) while controlling for actor and partner effects. METHODS This secondary data analysis of 277 dyads consisted of a series of multilevel models to examine the impact of dyadic congruence on a patient's self-care maintenance, symptom perception, and self-care management. Patient-level and caregiver-level data were input into each model simultaneously to account differential appraisals of factors related to the dyad. RESULTS Bivariate analyses yielded dyad congruence which was associated with better patient self-care maintenance, symptom perception and management. However, after multilevel models were constructed, dyad congruence was found to be a significant predictor of patient's symptom perception scores, but not self-care maintenance or management scores. Caregiver's satisfaction with the dyad was differentially and significantly associated with self-care - it was inversely associated with patient self-care maintenance and positively associated with patient self-care management. CONCLUSION This is the first study, to our knowledge, reporting that congruence in heart failure dyads is associated with better patient symptom perception and this advances our prior hypothesis that dyad typologies could be used to predict patient self-care performance. Since symptom perception is the key to preventing heart failure exacerbation, screening heart failure patient and caregiver dyads for congruence is important in clinical settings.
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Affiliation(s)
| | - Harleah Buck
- College of Nursing, University of South Florida, USA
| | - Valentina Zeffiro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Hailey Morgan
- College of Nursing, University of South Florida, USA
| | | | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
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Irani E, Moore SE, Hickman RL, Dolansky MA, Josephson RA, Hughes JW. The Contribution of Living Arrangements, Social Support, and Self-efficacy to Self-management Behaviors Among Individuals With Heart Failure: A Path Analysis. J Cardiovasc Nurs 2020; 34:319-326. [PMID: 31058704 PMCID: PMC6557687 DOI: 10.1097/jcn.0000000000000581] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Living arrangements, social support, and self-efficacy have significant implications for self-management science. Despite the theoretical linkages among the 3 concepts, there is limited empirical evidence about their interplay and the subsequent influence on heart failure (HF) self-management. OBJECTIVE The aim of this study was to validate components of the Individual and Family Self-management Theory among individuals with HF. METHODS This is a secondary analysis of cross-sectional data generated from a sample of 370 individuals with HF. A path analysis was conducted to examine the indirect and direct associations among social environment (living arrangements), social facilitation (social support) and belief (self-efficacy) processes, and self-management behaviors (HF self-care maintenance) while accounting for individual and condition-specific factors (age, sex, race, and HF disease severity). RESULTS Three contextual factors (living arrangements, age, and HF disease severity) had direct associations with perceived social support and self-efficacy, which in turn were positively associated with HF self-management behaviors. Living alone (β = -.164, P = .001) was associated with lower perceived social support, whereas being an older person (β = .145, P = .004) was associated with better support. Moderate to severe HF status (β = -.145, P = .004) or higher levels of perceived social support (β = .153, P = .003) were associated with self-efficacy. CONCLUSIONS Our results support the Individual and Family Self-management Theory, highlighting the importance of social support and self-efficacy to foster self-management behaviors for individuals with HF. Future research is needed to further explore relationships among living arrangements, perceived and received social support, self-efficacy, and HF self-management.
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Affiliation(s)
- Elliane Irani
- Elliane Irani, PhD, RN Postdoctoral Fellow, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. Scott Emory Moore, PhD, APRN, AGPCNP-BC Assistant Professor, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. Ronald L. Hickman, PhD, RN, ACNP-BC, FNAP, FAAN Associate Professor and Associate Dean for Research, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. Mary A. Dolansky, PhD, RN, FAAN Associate Professor, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. Richard A. Josephson, MS, MD Professor, School of Medicine, Case Western Reserve University; and Director of Cardiovascular and Pulmonary Rehabilitation, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio. Joel W. Hughes, PhD Professor, Department of Psychological Sciences, Kent State University, Ohio
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Characteristics of self-care interventions for patients with a chronic condition: A scoping review. Int J Nurs Stud 2020; 116:103713. [PMID: 32768137 DOI: 10.1016/j.ijnurstu.2020.103713] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 07/03/2020] [Accepted: 07/07/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Self-care is a fundamental element of treatment for patients with a chronic condition and a major focus of many interventions. A large body of research exists describing different types of self-care interventions, but these studies have never been compared across conditions. Examination of heterogeneous interventions could provide insights into effective approaches that should be used in diverse patient populations. OBJECTIVES To provide a comprehensive and standardized cross-condition overview of interventions to enhance self-care in patients with a chronic condition. Specific aims were to: 1) identify what self-care concepts and behaviors are evaluated in self-care interventions; 2) classify and quantify heterogeneity in mode and type of delivery; 3) quantify the behavior change techniques used to enhance self-care behavior; and 4) assess the dose of self-care interventions delivered. DESIGN Scoping review DATA SOURCES: Four electronic databases - PubMed, EMBASE, PsychINFO and CINAHL - were searched from January 2008 through January 2019. ELIGIBILITY CRITERIA FOR STUDY SELECTION Randomized controlled trials (RCTs) with concealed allocation to the intervention were included if they compared a behavioral or educational self- care intervention to usual care or another self-care intervention and were conducted in adults. Nine common chronic conditions were included: hypertension, coronary artery disease, arthritis, chronic kidney disease, heart failure, stroke, asthma, chronic obstructive lung disease, and type 2 diabetes mellitus. Diagnoses that are psychiatric (e.g. schizophrenia), acute rather than chronic, or benefitting little from self-care (e.g. dementia) were excluded. Studies had to be reported in English with full-text available. RESULTS 9309 citations were considered and 233 studies were included in the final review. Most studies addressed type 2 diabetes mellitus (n = 85; 36%), hypertension (n = 32; 14%) or heart failure (n = 27; 12%). The majority (97%) focused on healthy behaviors like physical activity (70%), dietary intake (59%), and medication management (52%). Major deficits found in self-care interventions included a lack of attention to the psychological consequences of chronic illness, technology and behavior change techniques were rarely used, few studies focused on helping patients manage signs and symptoms, and the interventions were rarely innovative. Research reporting was generally poor. CONCLUSIONS Major gaps in targeted areas of self-care were identified. Opportunities exist to improve the quality and reporting of future self-care intervention research. Registration: The study was registered in the PROSPERO database (#123,719).
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Vellone E, Lorini S, Ausili D, Alvaro R, Di Mauro S, De Marinis MG, Matarese M, De Maria M. Psychometric characteristics of the caregiver contribution to self-care of chronic illness inventory. J Adv Nurs 2020; 76:2434-2445. [PMID: 32538503 DOI: 10.1111/jan.14448] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 04/23/2020] [Accepted: 06/02/2020] [Indexed: 11/27/2022]
Abstract
AIM The purpose of the this study was to test the factorial structure, internal consistency reliability and concurrent validity of the Caregiver Contribution to Self-Care Chronic Illness Inventory. BACKGROUND Existing measures of caregiver contribution to self-care are disease-specific or behaviour-specific; no generic measures exist. DESIGN A cross-sectional study. METHOD Between April 2017 - December 2018, we enrolled a convenience sample of 358 patients with chronic illnesses and their caregivers. Patients completed the Self-Care of Chronic Illness Inventory while caregivers completed the Caregiver Contribution to Self-Care of Chronic Illness Inventory, a modification of the Self-Care of Chronic Illness Inventory, which includes three scales as follows: the Caregiver Contribution to Self-Care Maintenance, the Caregiver Contribution to Self-Care Monitoring and the Caregiver Contribution to Self-Care Management. Of each scale, we tested the factorial structure with confirmatory factor analysis and reliability with the factor score determinacy coefficient, the global reliability index for multidimensional scale and Cronbach's alpha. Also, we used Pearson's correlations for concurrent validity purposes. RESULTS Confirmatory factor analysis supported the two-factor structure of the Caregiver Contribution to Self-Care Maintenance and Management scales and the one-factor structure of the Caregiver Contribution to Self-Care Monitoring scale. A simultaneous confirmatory factor analysis on the combined set of items supported the more general model (Comparative Fit Index = 0.933). Reliability estimates ranged between 0.701 and 0.961 across the three scales. Concurrent validity of Caregiver Contribution to Self-Care of Chronic Illness Inventory with the Self-Care of Chronic Illness Inventory was not sufficiently supported since weak correlations were found. CONCLUSION The Caregiver Contribution to Self-Care of Chronic Illness Inventory is valid and reliable and can be used in clinical practice and research. IMPACT The Caregiver Contribution to Self-Care of Chronic Illness Inventory is an useful instrument to evaluate the extent to which caregivers contribute to patient self-care in chronic illnesses.
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Affiliation(s)
- Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Silvia Lorini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Stefania Di Mauro
- Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | | | - Maria Matarese
- School of Nursing, University Campus Bio-Medico, Rome, Italy
| | - Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Gould KA. Family and caregiver relationships influence patient self-management of heart failure. Evid Based Nurs 2020; 24:ebnurs-2019-103247. [PMID: 32554402 DOI: 10.1136/ebnurs-2019-103247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2020] [Indexed: 06/11/2023]
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Kim EY, Oh S, Son YJ. Caring experiences of family caregivers of patients with heart failure: A meta-ethnographic review of the past 10 years. Eur J Cardiovasc Nurs 2020; 19:473-485. [DOI: 10.1177/1474515120915040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Living with heart failure, a debilitating disease with an unpredictable course, requires ongoing adaptation and management not only from patients but also from their families. Family caregivers have been known to be key facilitators of self-management of heart failure. An integrative understanding of the experiences of family caregivers will provide essential information for improving the quality of life of persons with heart failure and their families. Aims: This study aimed to integrate and synthesize the findings of qualitative studies on family members’ experiences of caring for patients with heart failure. Methods: We employed the meta-ethnography methodology. Five electronic bibliographic databases were used to retrieve studies published from April 2009–March 2019 that explored family caregivers’ experiences of caring for patients with heart failure. Twelve qualitative studies were finally included for the synthesis, based on the eligibility criteria. Results: Three themes were identified: “shouldering the entire burden,” “starting a new life,” and “balancing caregiving and everyday life.” These three themes illustrate how family caregivers fulfilled caregiving roles, what helped them juggle their multiple responsibilities, and how they struck a balance between life as caregivers and individuals in their own right. Conclusion: This review provides a deeper understanding of family caregivers’ experiences of caring for patients with heart failure. The findings can help healthcare providers in the development and implementation of tailored interventions for both patients and family caregivers.
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Affiliation(s)
- Eun Young Kim
- Red Cross College of Nursing, Chung-Ang University, Republic of Korea
| | - Seieun Oh
- College of Nursing, Dankook University, Republic of Korea
| | - Youn-Jung Son
- Red Cross College of Nursing, Chung-Ang University, Republic of Korea
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Iovino P, Lyons KS, De Maria M, Vellone E, Ausili D, Lee CS, Riegel B, Matarese M. Patient and caregiver contributions to self-care in multiple chronic conditions: A multilevel modelling analysis. Int J Nurs Stud 2020; 116:103574. [PMID: 32276720 DOI: 10.1016/j.ijnurstu.2020.103574] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/22/2020] [Accepted: 03/07/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Multiple chronic conditions (MCC) are highly prevalent worldwide, especially among older populations. Patient self-care and care partner (or caregiver) contributions to self-care are recommended to reduce the impact of MCC and improve patients' outcomes. OBJECTIVES To describe patient self-care and care partner contributions to self-care and to identify determinants of patient self-care and care partner contributions to self-care at the patient and care partner level. DESIGN Multicentre cross-sectional study. SETTING Outpatient and community settings in Italy. PARTICIPANTS A sample of 340 patients with MCC and care partner dyads was recruited between 2017 and 2018. METHODS We measured patient's self-care and care partner contributions to self-care in dyads using the Self-care of Chronic Illness Inventory and the Caregiver Contribution to Self-care of Chronic Illness Inventory. To control for dyadic interdependence, we performed a multilevel modelling analysis. RESULTS Patients' and care partners' mean ages were 76.65 (± 7.27) and 54.32 (± 15.25), respectively. Most care partners were female and adult children or grandchildren. The most prevalent chronic conditions in patients were diabetes (74%) and heart failure (34%). Patients and care partners reported higher levels of self-care monitoring than self-care maintenance and management behaviours. Important patient clinical determinants of self-care included cognitive status, number of medications and type of chronic condition. Care partner determinants of self-care contributions included age, gender, education, perceived income, care partner burden, caregiving hours per week and the presence of a secondary care partner. CONCLUSIONS Our findings support the importance of taking a dyadic approach when focusing on patients with MCC and their care partners. More dyadic longitudinal research is recommended to reveal the modifiable determinants of self-care and the complex relationships between patients and care partners in the context of MCC.
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Affiliation(s)
- Paolo Iovino
- University of Rome "Tor Vergata", Rome, Italy; Australian Catholic University, Melbourne, Australia.
| | | | | | | | | | | | - Barbara Riegel
- University of Pennsylvania, Philadelphia, United States.
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Santos GC, Liljeroos M, Dwyer AA, Jaques C, Girard J, Strömberg A, Hullin R, Schäfer-Keller P. Symptom perception in heart failure - Interventions and outcomes: A scoping review. Int J Nurs Stud 2020; 116:103524. [PMID: 32063295 DOI: 10.1016/j.ijnurstu.2020.103524] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/12/2019] [Accepted: 01/02/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Symptom perception in heart failure has recently been described as essential in the self-care process bridging self-care maintenance and self-care management. Accordingly, symptom perception appears to be critical for improving patient outcomes such as decreased hospital readmission and increased survival. OBJECTIVES To explore what interventions have been reported on heart failure symptom perception and to describe outcomes responsive to symptom perception. DESIGN We conducted a scoping review using PRISMA Extension for Scoping Reviews. DATA SOURCES Structured searches of Medline, PubMed, Embase, CINAHL, PsychINFO, Web of Science, Cochrane, Joanna Briggs Institute and Grey literature databases. REVIEW METHODS Two authors independently screened references for eligibility. Eligible articles were written in English, French, German, Swedish, Italian or Spanish and concerned symptom perception in adults with heart failure. Data were extracted and charted in tables by three reviewers. Results were narratively summarized. RESULTS We identified 99 eligible studies from 3055 references. Seven interventional studies targeted symptom perception as the single intervention component. Mixed results have been found: while some reported decreased symptom frequency, intensity and distress, enhanced health-related quality of life, improved heart failure self-care maintenance and management as well as a greater ability to mention heart failure symptoms, others found more contacts with healthcare providers or no impact on anxiety, heart failure self-care nor a number of diary reported symptoms. Additional interventional studies included symptom perception as one component of a multi-faceted intervention. Outcomes responsive to symptom perception were improved general and physical health, decreased mortality, heart failure decompensation, as hospital/emergency visits, shorter delays in seeking care, more consistent weight monitoring, improved symptom recognition as well as self-care management, decreased hospital length of stay and decreased costs. CONCLUSIONS While many studies allowed to map a comprehensive overview of interventions supporting symptom perception in heart failure as well as responsiveness to outcomes, only a few single component intervention studies targeting symptom perception have been reported and study designs preclude assessing intervention effectiveness. With regard to multiple component interventions, the specific impact of symptom perception interventions on outcomes remains uncertain to date. Well-designed studies are needed to test the effectiveness of symptom perception interventions and to elucidate relationships with outcomes.
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Affiliation(s)
- Gabrielle Cécile Santos
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland Fribourg, Haute Ecole de Santé Fribourg, Route des Arsenaux 16a, CH-1700 Fribourg, Switzerland; PhD Student at Institute of Higher Education and Research in Healthcare IUFRS, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, SV-A Secteur Vennes, Route de la Corniche 10, CH-1010 Lausanne, Switzerland.
| | - Maria Liljeroos
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden; Centre for Clinical Research Sörmland, Uppsala University, 631 88 Eskilstuna, Sweden.
| | - Andrew A Dwyer
- William F. Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Chestnut Hill, Massachusetts 02467, United State of America.
| | - Cécile Jaques
- Medical Library, Research and Education Department, Lausanne University Hospital, Route du Bugnon 46, CH-1011 Lausanne, Switzerland.
| | - Josepha Girard
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland Fribourg, Haute Ecole de Santé Fribourg, Route des Arsenaux 16a, CH-1700 Fribourg, Switzerland.
| | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden.
| | - Roger Hullin
- Department of cardiology, Lausanne University Hospital, Route du Bugnon 46, CH-1011 Lausanne, Switzerland; Faculty of biology and medicine, University of Lausanne, CH-1015 Lausanne, Switzerland.
| | - Petra Schäfer-Keller
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland Fribourg, Haute Ecole de Santé Fribourg, Route des Arsenaux 16a, CH-1700 Fribourg, Switzerland.
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Durante A, Greco A, Annoni AM, Steca P, Alvaro R, Vellone E. Determinants of caregiver burden in heart failure: does caregiver contribution to heart failure patient self-care increase caregiver burden? Eur J Cardiovasc Nurs 2019; 18:691-699. [PMID: 31319698 DOI: 10.1177/1474515119863173] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The burden is high in caregivers of heart failure patients, but the literature on patient and caregiver predictors of caregiver burden is inconsistent. Also, it is unknown if caregiver contribution to heart failure self-care maintenance (i.e. helping patients to maintain heart failure stable) and self-care management (i.e. helping patients to act in case of heart failure worsening) increases caregiver burden. AIMS To identify caregiver and patient predictors of caregiver burden in heart failure; and to evaluate if caregiver contribution to heart failure self-care maintenance and management increases caregiver burden. METHODS A cross-sectional study with the enrolment of 505 caregivers of heart failure patients. We used the caregiver burden inventory and the caregiver contribution to self-care of heart failure index. We analysed the data using hierarchical regression. RESULTS Heart failure caregivers, mostly women (52.5%), with a mean age 56.5 (±14.9) years, cared for heart failure patients, mostly men (55.2%), with a mean age of 75.9 (±10.4) years. Caregiver predictors of higher caregiver burden were older age, female gender, fewer caregiving hours and poor social support. Patient predictors of higher caregiver burden were older age, better education, taking fewer medications and higher quality of life. Caregiver contribution to self-care maintenance and management were not significant predictors of caregiver burden. CONCLUSIONS Our results could help providers to identify heart failure caregivers who are more exposed to burden. As caregiver contribution to heart failure self-care improves patient outcomes and seems not burdensome for caregivers, providers may consider educating caregivers about self-care as a viable option for improving patient outcomes without increasing caregiver burden.
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Affiliation(s)
- Angela Durante
- Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Italy
| | - Andrea Greco
- Department of Psychology, University of Milan 'Bicocca', Italy
| | | | - Patrizia Steca
- Department of Psychology, University of Milan 'Bicocca', Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Italy
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