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Li X, Zhang J, Li J, Fang W, Zhang X, Fan X. Determinants of preparedness in family caregivers of patients with heart failure. Eur J Cardiovasc Nurs 2024:zvae107. [PMID: 39132774 DOI: 10.1093/eurjcn/zvae107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 04/14/2024] [Accepted: 07/24/2024] [Indexed: 08/13/2024]
Abstract
AIMS Inadequate preparedness of family caregivers contributes to adverse outcomes of patients with heart failure (HF). However, evidence on caregiver preparedness is limited. This study aims to examine the determinants and potential mechanisms of preparedness in family caregivers of patients with HF. METHODS AND RESULTS In the cross-sectional study, 298 HF patient-caregiver dyads were recruited from 4 tertiary hospitals in China. Preparedness, uncertainty in illness, family relational quality, social support, and positive aspects of caregiving (PAC) were assessed in family caregivers using self-reported questionnaires. In the path analysis model, uncertainty in illness had an indirect negative effect on preparedness via reduced PAC [indirect effect = -0.020; 95% confidence interval (CI) -0.050 to -0.002]. Whereas, family relational quality had direct (β = 0.266; P < 0.001) and indirect positive effects on preparedness through increased PAC (indirect effect = 0.027; 95% CI, 0.003-0.067). Similarly, social support also had direct (β = 0.184; P = 0.004) and indirect positive effects on preparedness through increased PAC (indirect effect = 0.027; 95% CI, 0.004-0.065). CONCLUSION This study highlights that diminishing uncertainty in illness may indirectly improve caregiver preparedness through the enhancement of PAC, while raising family relational quality and social support may improve caregiver preparedness both directly and indirectly by augmenting PAC. These findings provide insightful implications for healthcare professionals in developing tailored interventions to ameliorate preparedness in family caregivers of patients with HF.
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Affiliation(s)
- Ximiao Li
- School of Nursing and Rehabilitation, Shandong University, No. 44, Wenhua Xi Rd, Jinan, Shandong 250012, P. R. China
| | - Jie Zhang
- Department of Health Care Cardiovascular, Shandong Provincial Hospital, Jinan, Shandong, P. R. China
| | - Jinliang Li
- School of Nursing and Rehabilitation, Shandong University, No. 44, Wenhua Xi Rd, Jinan, Shandong 250012, P. R. China
| | - Wenjie Fang
- School of Nursing and Rehabilitation, Shandong University, No. 44, Wenhua Xi Rd, Jinan, Shandong 250012, P. R. China
| | - Xiuting Zhang
- School of Nursing and Rehabilitation, Shandong University, No. 44, Wenhua Xi Rd, Jinan, Shandong 250012, P. R. China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Shandong University, No. 44, Wenhua Xi Rd, Jinan, Shandong 250012, P. R. China
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Graven LJ, Durante A, Abbott L, Bassi E, Howren MB, Grant JS. Self-care Problems and Management Strategies Experienced by Rural Patient/Caregiver Dyads Living With Heart Failure: A Qualitative Study. J Cardiovasc Nurs 2024; 39:207-218. [PMID: 37955387 DOI: 10.1097/jcn.0000000000001056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
BACKGROUND Rural patients with heart failure (HF) have higher mortality and hospitalization rates compared with their urban counterparts. Although research supports the inclusion of informal caregivers in daily self-care activities, data are limited regarding the problems encountered by rural patient/caregiver dyads living with HF in managing HF in the home and how these problems are managed. OBJECTIVE The aim of this study was to identify and describe HF self-care problems experienced by rural dyads in the home and how these problems are managed. METHODS Using a descriptive qualitative design, data were collected from rural patient/caregiver dyads living with HF via individual, semistructured, telephone interviews and analyzed using schematic content analysis. Interviews and data analysis occurred concurrently until data saturation was reached. RESULTS Thematic data saturation was obtained with 11 dyads. On average, patients were 65.3 (±13.9) years old, and caregivers were 62 (±12.37) years old. Four themes illustrating dyadic HF self-care problems and management strategies emerged: (1) HF self-care components, namely, maintenance, symptom monitoring, and management (diet, exercise, activities, strategies); (2) environment (rural barriers, COVID-19); (3) caregiver contributors (confidence, role); and (4) dyadic contributors (dyadic relationship). Dyads described various self-care problems, with the type of relationship and presence of mutuality influencing the problem-solving process and development of management strategies. CONCLUSIONS The identified themes emphasize the self-care problems experienced by rural dyads living with HF and the contributions of both dyad members to effectively manage these challenges. Findings support the need for culturally sensitive, tailored interventions targeting self-care in rural dyads living with HF.
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Locatelli G, Iovino P, Jurgens CY, Alvaro R, Uchmanowicz I, Rasero L, Riegel B, Vellone E. The Influence of Caregiver Contribution to Self-care on Symptom Burden in Patients With Heart Failure and the Mediating Role of Patient Self-care: A Longitudinal Mediation Analysis. J Cardiovasc Nurs 2024; 39:255-265. [PMID: 37550831 DOI: 10.1097/jcn.0000000000001024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
BACKGROUND Patients with heart failure experience high symptom burden, which can be mitigated with adequate self-care. Caregiver contribution to self-care has been theorized to improve patient symptom burden. The mediating role of patient self-care in this relationship has not been tested yet. OBJECTIVES The aim of this study was to test whether ( a ) caregiver contribution to self-care influences patient self-care, ( b ) patient self-care influences symptom burden, and ( c ) patient self-care mediates the relationship between caregiver contribution to self-care and symptom burden. METHODS In this study, the authors conducted a secondary analysis of the baseline and 3-month data from the MOTIVATE-HF trial, which enrolled 510 dyads (patient with heart failure and caregiver) in Italy. Multigroup confirmatory factor analysis was used to test measurement invariance. Autoregressive longitudinal path analysis with contemporaneous mediation was used to test our hypotheses. RESULTS On average, caregivers were 54 years old and mainly female, whereas patients were 72.4 years old and mainly male. Better caregiver contribution to self-care maintenance was associated with better patient self-care maintenance (β = 0.280, P < .001), which, in turn, was associated with lower symptom burden (β = -0.280, P < .001). Patient self-care maintenance mediated the effect of caregiver contribution to self-care maintenance on symptom burden (β = -0.079; 95% bias-corrected bootstrapped confidence interval, -0.130 to -0.043). Better caregiver contribution to self-care management was associated with better patient self-care management (β = 0.238, P = .006). The model significantly accounted for 37% of the total variance in symptom burden scores ( P < .001). CONCLUSIONS This study expands the situation-specific theory of caregiver contribution to heart failure self-care and provides new evidence on the role of caregiver contribution to self-care and patient self-care on symptom burden in heart failure.
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Wang Y, Xu X, Lv Q, Zhao Y, Zhang X, Zang X. Network Analysis of Dyadic Burdens, Psychological Disorders, Psychological Resilience, and Illness- or Caregiving-Related Beliefs in Patients With Chronic Heart Failure and Their Caregivers. J Cardiovasc Nurs 2024:00005082-990000000-00184. [PMID: 38622773 DOI: 10.1097/jcn.0000000000001098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Previous research has examined the dyadic health components consisting of dyadic burdens, psychological disorders, psychological resilience, and illness- or caregiving-related beliefs independently from each other in patients with chronic heart failure (CHF) and their caregivers, but there is a need for further insights into their interconnections. OBJECTIVE We aimed to explore the interconnections among dyadic health components in patients with CHF and their caregivers. METHODS We conducted a cross-sectional study, recruiting in a total of 355 patients with CHF and their 355 respective caregivers, totaling 710 individuals across the dyads. Assessments were conducted on symptom burden, caregiver burden, anxiety, depression, psychological resilience, perceived control, and caregiver self-efficacy. Network analysis was used regarding these constructs as nodes and their associations as edges. RESULTS The strongest edge weight was observed between patients' anxiety and depression, followed by caregivers' anxiety and depression. Patients' depression exhibited the strongest edge weight with dyadic burdens. Caregiver burden was independently correlated with all nodes. Patients' symptom burden had fewer associations with the nodes within the caregiver community. Patients' anxiety, depression, and psychological resilience demonstrated the strongest and most influential correlations with other nodes. CONCLUSIONS The findings illustrated extensive interconnections among dyadic health components in CHF dyads. These findings underscored the significance of managing and intervening with patients and caregivers as a dyadic whole. Given the strong and frequent associations of patients' anxiety, depression, and psychological resilience with other nodes in the network, interventions targeting these nodes may enhance the overall network health of CHF dyads.
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Cheng M, Zhu C, Ge Y, Ke Y, Shi Y, Su Y, Ma T, Chi M, Wang N, Lu B, Hou Y. The impact of informal caregivers' preparedness on short-term outcomes of heart failure patients with insufficient self-care. Eur J Cardiovasc Nurs 2023; 22:628-637. [PMID: 36306414 DOI: 10.1093/eurjcn/zvac102] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 09/06/2023]
Abstract
AIMS Even though self-care is essential in the long-term management of heart failure (HF), it is often not performed adequately in HF populations. Mobilizing informal caregivers may be one way to help patients perform self-care, support individual needs, and maintain health. However, informal caregivers often face insufficient preparation for providing long-term care. This insufficient caregiver preparedness may lead to a decline in caregiver contributions and affect the outcomes of care in patients with HF. This study aimed to explore whether informal caregivers' preparedness is a predictor that influences short-term outcomes of HF patients; to analyse whether caregiver contribution to self-care of HF (CC-SCHF) plays a mediating role between informal caregivers' preparedness and HF short-term outcomes. METHODS AND RESULTS A prospective observational study was conducted in China. After controlling for covariates, higher levels of informal caregivers' preparedness were significantly associated with lower 3-month mortality [odds ratio (OR) = 0.919, 95% confidence interval (CI) = (0.855-0.988), P = 0.022] and 3-month readmission rate [OR = 0.883, 95% CI = (0.811-0.961), P = 0.004] and shorter length of hospital stay (β = -0.071, P < 0.001). The informal caregiver's preparedness was positively associated with CC-SCHF maintenance (r = 0.708, P < 0.01), CC-SCHF management (r = 0.431, P < 0.01), and CC-SCHF confidence (r = 0.671, P < 0.01). The CC-SCHF management was a mediator in the relationship between informal caregivers' preparedness and 3-month readmission rate [effect 95% CI = (-0.054 to -0.001)] and length of hospital stay [effect 95% CI = (-0.235 to -0.042)]. CONCLUSION A higher level of informal caregivers' preparedness is associated with better short-term outcomes of HF patients with insufficient self-care.
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Affiliation(s)
- Ming Cheng
- Department of Cardiology, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou 215006, China
- School of Nursing, Suzhou Medical College of Soochow University, No. 1 Shizi Street, Suzhou, Jiangsu, China
| | - Chenya Zhu
- Department of Cardiology, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou 215006, China
- School of Nursing, Suzhou Medical College of Soochow University, No. 1 Shizi Street, Suzhou, Jiangsu, China
| | - Yingying Ge
- School of Nursing, Suzhou Medical College of Soochow University, No. 1 Shizi Street, Suzhou, Jiangsu, China
| | - Yufei Ke
- School of Nursing, Suzhou Medical College of Soochow University, No. 1 Shizi Street, Suzhou, Jiangsu, China
| | - Yixing Shi
- School of Nursing, Suzhou Medical College of Soochow University, No. 1 Shizi Street, Suzhou, Jiangsu, China
| | - Yue Su
- School of Nursing, Suzhou Medical College of Soochow University, No. 1 Shizi Street, Suzhou, Jiangsu, China
| | - Tianyu Ma
- School of Nursing, Suzhou Medical College of Soochow University, No. 1 Shizi Street, Suzhou, Jiangsu, China
| | - Meixuan Chi
- School of Nursing, Suzhou Medical College of Soochow University, No. 1 Shizi Street, Suzhou, Jiangsu, China
| | - Naijuan Wang
- School of Nursing, Suzhou Medical College of Soochow University, No. 1 Shizi Street, Suzhou, Jiangsu, China
| | - Bingqing Lu
- Department of Cardiology, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou 215006, China
| | - Yunying Hou
- Department of Cardiology, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou 215006, China
- School of Nursing, Suzhou Medical College of Soochow University, No. 1 Shizi Street, Suzhou, Jiangsu, China
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Locatelli G, Rebora P, Occhino G, Ausili D, Riegel B, Cammarano A, Uchmanowicz I, Alvaro R, Vellone E, Zeffiro V. The Impact of an Intervention to Improve Caregiver Contribution to Heart Failure Self-care on Caregiver Anxiety, Depression, Quality of Life, and Sleep. J Cardiovasc Nurs 2023:00005082-990000000-00090. [PMID: 37204336 DOI: 10.1097/jcn.0000000000000998] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
BACKGROUND Better caregiver contribution to self-care in heart failure is associated with better patient outcomes. However, caregiver contribution to self-care is also associated with high anxiety and depression, poor quality of life, and poor sleep in caregivers. It is still unclear whether interventions that encourage caregivers to contribute more to patient self-care might increase caregivers' anxiety and depression and decrease their quality of life and sleep. OBJECTIVE The aim of this study was to assess the impact of a motivational interview intervention aimed at improving caregiver contribution to self-care in heart failure on caregivers' anxiety, depression, quality of life, and sleep. METHODS This is a secondary outcome analysis of the MOTIVATE-HF trial. Patients with heart failure and their caregivers were randomized into arm 1 (motivational interview to patients), arm 2 (motivational interview to patients and caregivers), and arm 3 (standard care). Data were collected between June 2014 and October 2018. The article has been prepared following the Consolidated Standards of Reporting Trials checklist. RESULTS A sample of 510 patient-caregiver dyads was enrolled. Over the year of the study, the levels of anxiety, depression, quality of life, and sleep in caregivers did not significantly change among the 3 arms. CONCLUSIONS Motivational interview aimed at improving caregiver contribution to self-care does not seem to increase caregiver anxiety and depression, nor decrease their quality of life and sleep. Thus, such an intervention might be safely delivered to caregivers of patients with heart failure, although further studies are needed to confirm our findings.
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Stawnychy MA, Ringel JB, Riegel B, Sterling MR. Better Preparation and Training Determine Home Care Workers' Self-Efficacy in Contributing to Heart Failure Self-Care. J Appl Gerontol 2023; 42:651-659. [PMID: 35801567 PMCID: PMC9825674 DOI: 10.1177/07334648221113322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE Identify determinants of home care workers' (HCW) self-efficacy in contributing to heart failure (HF) self-care. METHODS Secondary analysis of a survey (n = 328) examining characteristics of HCWs caring for adults with HF in New York. Self-efficacy assessed using Caregiver Self-Efficacy in Contributing to Self-Care Scale. Standardized scores range 0-100; ≥ 70 points indicate adequate self-efficacy. Characteristics determined by self-efficacy (low vs. adequate). Prevalence ratios with 95% confidence intervals (PR [95% CI]) were estimated using multivariable Poisson regression with robust standard errors. RESULTS Home care workers with adequate self-efficacy had at least some prior HF training (55% vs. 17%, p < .001) and greater job satisfaction (90% vs. 77%, p = .003). Significant determinants for adequate self-efficacy were employment length (1.02 [1.00-1.03], p = .027), preparation for caregiving (3.10 [2.42-3.96], p < .001), and HF training (1.48 [1.20-1.84], p < .001). CONCLUSION Home care agencies and policy-makers can target caregiving preparation and HF training to improve HCWs' confidence in caring for adult HF patients.
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Affiliation(s)
- Michael A. Stawnychy
- Robert Wood Johnson Foundation Future of Nursing Scholar
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
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Dellafiore F, Ghizzardi G, Vellone E, Magon A, Conte G, Baroni I, De Angeli G, Vangone I, Russo S, Stievano A, Arrigoni C, Caruso R. A Single-Center, Randomized Controlled Trial to Test the Efficacy of Nurse-Led Motivational Interviewing for Enhancing Self-Care in Adults with Heart Failure. Healthcare (Basel) 2023; 11:773. [PMID: 36900778 PMCID: PMC10000833 DOI: 10.3390/healthcare11050773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/21/2023] [Accepted: 03/05/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND The role of nurse-led motivational interviewing (MI) in improving self-care among patients with heart failure (HF) is promising, even if it still requires further empirical evidence to determine its efficacy. For this reason, this study tested its efficacy in enhancing self-care maintenance (primary endpoint), self-care management, and self-care confidence after three months from enrollment in adults with HF compared to usual care, and assessed changes in self-care over follow-up times (3, 6, 9, and 12 months). METHODS A single-center, randomized, controlled, parallel-group, superiority study with two experimental arms and a control group was performed. Allocation was in a 1:1:1 ratio between intervention groups and control. RESULTS MI was effective in improving self-care maintenance after three months when it was performed only for patients (arm 1) and for the patients-caregivers dyad (arm 2) (respectively, Cohen's d = 0.92, p-value < 0.001; Cohen's d = 0.68, p-value < 0.001). These effects were stable over the one-year follow-up. No effects were observed concerning self-care management, while MI moderately influenced self-care confidence. CONCLUSIONS This study supported the adoption of nurse-led MI in the clinical management of adults with HF.
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Affiliation(s)
- Federica Dellafiore
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, 27100 Pavia, Italy
| | - Greta Ghizzardi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
- Department of Nursing and Obstetrics, Wroclaw Medical University, 50-368 Wrocław, Poland
| | - Arianna Magon
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
| | - Gianluca Conte
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
| | - Irene Baroni
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
| | - Giada De Angeli
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
| | - Ida Vangone
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, 27100 Pavia, Italy
| | - Sara Russo
- Nursing Degree Course, Section Istituti Clinici di Pavia e Vigevano S.p.a., University of Pavia, 27100 Pavia, Italy
| | - Alessandro Stievano
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
- Centre of Excellence for Nursing Scholarship, OPI, 00136 Rome, Italy
| | - Cristina Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, 27100 Pavia, Italy
| | - Rosario Caruso
- Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
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Sollazzo F, Di Nitto M, Rosito L, Torino F, Alvaro R, Lacarbonara F, Vellone E, Durante A. Caregivers’ contribution to self-care for patients treated with oral anticancer agents: A qualitative descriptive study. Eur J Oncol Nurs 2023; 64:102327. [PMID: 37156057 DOI: 10.1016/j.ejon.2023.102327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023]
Abstract
PURPOSE To adequately manage oral anticancer agents (OAAs) therapy, appropriate self-care behaviours must be implemented. Informal caregivers could support and contribute to patient self-care. This study aimed to explore and describe the caregiver contribution to self-care and their related experience of caring among informal caregivers of patients on OAAs. METHODS Qualitative descriptive design. We conducted semi-structured interviews, which were transcribed, read in depth, and analysed with deductive and inductive content analysis, according to Mayring. Adult informal caregivers (>18 years) of elderly patients (>65 years) with solid malignancies undergoing OAAs therapy for at least 3 months were included. FINDINGS Twenty-three caregivers were interviewed with mean age of 57,2 (SD ± 15,8). A total of 18 codes from the qualitative content analysis were found, of which ten were referred to caregiver contribution and classified into the three dimensions of self-care maintenance (i.e. behaviours to maintain illness stable), self-care monitoring (i.e., tracking symptoms and side effects), and self-care management (i.e., management of worsening symptoms), according to the Middle Range Theory of Self-Care of Chronic Illnesses. The eight codes on caregiver experience were aggregated into two main themes: negative aspects (i.e., burden, emotional state, self-denial, social isolation) and positive aspects of caregiving. CONCLUSION Healthcare professionals should consider the importance of caregiver role in supporting their loved one treated with OAAs, also taking into account their needs to prevent burdensome situations. A holistic view in which a patient-centred approach is established should be encouraged through the communication and education of the dyad.
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The Influence of Informal Caregivers' Preparedness on Psychological Symptoms and Quality of Life Among Patients With Heart Failure And Insufficient Self-care. J Cardiovasc Nurs 2023; 38:224-236. [PMID: 36745758 DOI: 10.1097/jcn.0000000000000975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Most patients with heart failure find self-care difficult to perform and rely on family caregivers for support. Informal caregivers, however, often face insufficient psychological preparation and challenges in providing long-term care. Insufficient caregiver preparedness not only results in psychological burden for the informal caregivers but may also lead to a decline in caregiver contributions to patient self-care that affects patient outcomes. OBJECTIVE Our objective was to test (1) the association of baseline informal caregivers' preparedness with psychological symptoms (anxiety and depression) and quality of life 3 months after baseline among patients with insufficient self-care and (2) the mediating effects of caregivers' contributions to self-care of heart failure (CC-SCHF) on the relationship of caregivers' preparedness with patients' outcomes at 3 months. METHODS A longitudinal design was used to collect data between September 2020 and January 2022 in China. Data analyses were conducted using descriptive statistics, correlations, and linear mixed models. We used model 4 of the PROCESS program in SPSS with bootstrap testing to evaluate the mediating effect of CC-SCHF of informal caregivers' preparedness at baseline with psychological symptoms or quality of life among patients with HF 3 months later. RESULTS Caregiver preparedness was positively associated with CC-SCHF maintenance (r = 0.685, P < .01), CC-SCHF management (r = 0.403, P < .01), and CC-SCHF confidence (r = 0.600, P < .01). Good caregiver preparedness directly predicted lower psychological symptoms (anxiety and depression) and higher quality of life for patients with insufficient self-care. The associations of caregiver preparedness with short-term quality of life and depression of patients with HF with insufficient self-care were mediated by CC-SCHF management. CONCLUSIONS Enhancing the preparedness of informal caregivers may improve psychological symptoms and quality of life of heart failure patients with insufficient self-care.
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Simonelli N, Bolgeo T, Iovino P, Di Matteo R, Maconi A, Vellone E. Self-care in coronary heart disease patient and caregiver dyads (HEARTS-IN-DYADS)-Protocol of a multicenter longitudinal study. Res Nurs Health 2023; 46:37-47. [PMID: 36538334 DOI: 10.1002/nur.22286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 11/18/2022] [Accepted: 11/26/2022] [Indexed: 12/24/2022]
Abstract
Self-care performed by patients and the caregiver contribution to this self-care are essential for improving cardiovascular outcomes; however, so far, no studies have sufficiently investigated this field in Italy. This paper describes a research protocol of a multi-center longitudinal study designed to investigate the self-care of patients affected by coronary heart disease (CHD), the caregiver's contribution to this self-care, the predictors of patient and caregiver self-care, the mediating role of self-efficacy, and the self-care outcomes. Data collection will be performed across seven Italian inpatient settings at baseline and 3 and 6 months from enrollment. Multilevel modeling and actor partner interdependence models will be implemented on a sample of 330 patient-caregiver dyads to adjust for the interdependence of measurements. The study received approval from an ethics committee in Italy and was financed in January 2021 by a grant from the Solidal Foundation in Alessandria. This research will advance the knowledge about the self-care process in CHD. The results will guide research and clinical practice by identifying variables sensitive to educational interventions.
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Affiliation(s)
- Niccolò Simonelli
- SC Cardiology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Tatiana Bolgeo
- Research Training Innovation Infrastructure - Department of Research and Innovation - Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Paolo Iovino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,School of Nursing Midwifery and Paramedicin Australian Catholic University, Melbourne, Victoria, Australia
| | - Roberta Di Matteo
- Research Training Innovation Infrastructure - Department of Research and Innovation - Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.,Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Antonio Maconi
- Research Training Innovation Infrastructure - Department of Research and Innovation - Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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Associations of perceived and common dyadic coping with self-care in older couples with cardiovascular disease: A dyadic analysis. Heart Lung 2023; 57:229-235. [PMID: 36270239 DOI: 10.1016/j.hrtlng.2022.09.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Dyadic engagement of patients and caregivers in self-care is essential for management of heart disease. However, little is known how dyadic coping at individual and partner levels is associated with self-care in couples living with cardiovascular disease. OBJECTIVE This study examined whether dyadic coping at self, partner, and common levels was associated with patients' engagement in self-care and spouses' contribution to self-care in older couples living with cardiovascular disease. METHODS In this cross-sectional study, 288 older patients and spouses were recruited from outpatient heart clinics in Qazvin, north of Iran. Data were collected using the Dyadic Coping Inventory, the Self-care of Coronary Heart Disease Inventory, and the Caregiver's Contribution to Self-care of Coronary Heart Disease. Dyadic data were analyzed using the actor-partner interdependence model. RESULTS The results showed that patients' engagement in self-care maintenance was associated with partner dyadic coping in patients, self and common dyadic coping in spouses. Patients' engagement in self-care monitoring was only associated with self dyadic coping in spouses. Dyadic analysis also showed that self-care confidence in patients was only associated with by partner dyadic coping in spouses. CONCLUSIONS This study revealed that self-care was associated with dyadic coping employed by each member of the dyad at self, partner and common levels. Findings of this study suggest that perceived and provided levels of dyadic coping can be employed for maintaining or restoring self-management in older couples living with cardiovascular disease.
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Karimi P, Mohammadi M, Mozaffari N. The relationship between caregiver contributions to self-care and quality of life in heart failure patients in Ardabil hospitals in Ardebil-Iran. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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14
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Chen C, Zhao Q, Zhang X, Yang Q, Dong X, Zhang Y, Fan X. The relationship between mutuality and contributions to self-care in family caregivers of patients with heart failure: multiple mediating effects of resilience and self-efficacy. Eur J Cardiovasc Nurs 2022; 21:812-820. [PMID: 35292823 DOI: 10.1093/eurjcn/zvac016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/16/2022] [Accepted: 03/02/2022] [Indexed: 12/29/2022]
Abstract
AIMS Previous studies have indicated a positive association between mutuality and caregiver contributions to heart failure self-care (CC-HFSC). However, little is known about the underlying mechanisms in the relationship. This study aimed to determine whether resilience and self-efficacy play multiple mediating roles in the association between mutuality and CC-HFSC. METHODS AND RESULTS In this cross-sectional, correlational study, a self-reported survey was conducted in 259 patient-caregiver dyads recruited from two hospitals in China using a convenience sampling method. Better mutuality (r = 0.27, P < 0.01), resilience (r = 0.23, P < 0.01), and self-efficacy (r = 0.34, P < 0.01) were correlated with greater CC-HFSC maintenance. Better mutuality (r = 0.29, P < 0.01), resilience (r = 0.20, P < 0.01), and self-efficacy (r = 0.35, P < 0.01) were correlated with greater CC-HFSC management. In multiple mediation models, self-efficacy independently [effect = 0.061, 95% confidence interval (CI) (0.024-0.119)] and resilience and self-efficacy serially [effect = 0.017, 95% CI (0.007-0.036)] mediated the association between mutuality and CC-HFSC maintenance. Meanwhile, self-efficacy independently [effect = 0.058, 95% CI (0.020-0.113)] and resilience and self-efficacy serially [effect = 0.018, 95% CI (0.007-0.038)] mediated the association between mutuality and CC-HFSC management. CONCLUSIONS Resilience and self-efficacy were multiple mediators in the association between mutuality and CC-HFSC. Interventions targeting the facilitation of mutuality, and then increasing resilience and self-efficacy may be beneficial for improving CC-HFSC.
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Affiliation(s)
- Cancan Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44# Wenhua Xi Road, Jinan, Shandong 250012, P.R. China
| | - Qiuge Zhao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44# Wenhua Xi Road, Jinan, Shandong 250012, P.R. China
| | - Xiuting Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44# Wenhua Xi Road, Jinan, Shandong 250012, P.R. China
| | - Qiaofang Yang
- Department of Nursing, Fuwai Central China Cardiovascular Hospital, 1# Fuwai Avenue, Zhengzhou, Henan, 451464, P.R. China
| | - Xiaoyu Dong
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44# Wenhua Xi Road, Jinan, Shandong 250012, P.R. China
| | - Yilin Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44# Wenhua Xi Road, Jinan, Shandong 250012, P.R. China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44# Wenhua Xi Road, Jinan, Shandong 250012, P.R. China
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15
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Locatelli G, Zeffiro V, Occhino G, Rebora P, Caggianelli G, Ausili D, Alvaro R, Riegel B, Vellone E. Effectiveness of Motivational Interviewing on contribution to self-care, self-efficacy, and preparedness in caregivers of patients with heart failure: a secondary outcome analysis of the MOTIVATE-HF randomized controlled trial. Eur J Cardiovasc Nurs 2022; 21:801-811. [PMID: 35290454 DOI: 10.1093/eurjcn/zvac013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/23/2021] [Accepted: 02/25/2022] [Indexed: 12/29/2022]
Abstract
AIMS Caregiver characteristics and behaviours are associated with patients' and caregivers' outcomes. However, there is scarce evidence on interventions aimed at improving caregiver contribution (CC) to patient self-care, caregiver self-efficacy, and caregiver preparedness in heart failure (HF). This study aims to evaluate the effect of Motivational Interviewing (MI) on CC to patient self-care, caregiver self-efficacy, and caregiver preparedness in HF. METHODS AND RESULTS This is a secondary outcome analysis of MOTIVATE-HF randomized controlled trial. Caregivers of patients with HF were randomized into three arms: Arm 1 (MI for patients), Arm 2 (MI for patients and caregivers), and Arm 3 (standard care). The intervention consisted of one MI session plus three telephone contacts. Data were collected at baseline and after 3, 6, 9, and 12 months. A total of 510 patient and caregiver (median age 54 years, 76% females) dyads were enrolled, 235 caregivers and 238 patients completed the study until 12 months. Caregiver contribution to self-care maintenance and management and caregiver preparedness significantly improved over time, but without significant differences among the three arms. At 9 months, caregiver self-efficacy improved more in Arm 2 than Arm 3 [difference: 8.36, 95% confidence interval (CI) (3.13; 13.59), P = 0.001]. This improvement remained significant also at linear mixed model [β^ = 1.39, 95% CI (0.02; 2.75), P = 0.046]. CONCLUSION Motivational Interviewing did not improve CC to patient self-care and caregiver preparedness. However, it increased caregiver self-efficacy, which is known to be a powerful mediator of CC to self-care. REGISTRATION Clinicaltrials.gov: NCT02894502.
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Affiliation(s)
- Giulia Locatelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1., 00133 Rome, Italy.,School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Victoria 3065, Australia
| | - Valentina Zeffiro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1., 00133 Rome, Italy
| | - Giuseppe Occhino
- Bicocca Bioinformatics, Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore, 48., 20900 Monza, Italy
| | - Paola Rebora
- Bicocca Bioinformatics, Biostatistics and Bioimaging Centre-B4, School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore, 48., 20900 Monza, Italy
| | - Gabriele Caggianelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1., 00133 Rome, Italy
| | - Davide Ausili
- Department of Medicine and Surgery, University of Milano Bicocca, Via Cadore 48, 20900 Monza, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1., 00133 Rome, Italy
| | - Barbara Riegel
- School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Victoria 3065, Australia.,School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA 19104-4217, USA
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1., 00133 Rome, Italy
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16
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AFŞAR F, KAYALI S, KESGİN V, AKGÜN T. The adaptation to Turkish of the caregiver contributions to selfcare of heart failure index: a validity and reliability study. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1147349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: Although heart failure is a chronic and progressive disease, it is also a disease that requires the patient and caregivers who are not healthcare professionals to spend many years together in the process of follow-up, treatment, and care. Correct evaluation of the patient and caregiver in this process is one of the most important points that will guide the process. The aim of this study was to conduct a validity and reliability study of the Turkish version of the Caregiver Contributions to Self-Care of Heart Failure Index v.2- (CC-SCHFI) and to determine the contributions of caregivers of patients with heart failure.
Material and Method: The study sample was formed of the caregivers of patients who presented at a training and research hospital with a diagnosis of heart failure, who voluntarily agreed to participate in the research. Data were collected using a Personal Information Form and the CC-SCHFI. For the reliability study of the language adaptation of the CC-SCHFI, the internal consistency coefficient and the item-total points reliability coefficient were used, and to determine structure validity, Explanatory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were applied.
Results: The cultural adaptation to Turkish of the CC-SCHFI was found to be high. In the validity and reliability study, the structure validity and internal consistency were high and it was concluded that the scale could be used under the sub-dimension headings of “Recommendations for Protection”, “The Role of the Caregiver in Treatment Compliance”, and “Caregiver Practices”.
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Affiliation(s)
- Füsun AFŞAR
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL DR. SİYAMİ ERSEK GÖĞÜS KALP VE DAMAR CERRAHİSİ SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
| | - Serpil KAYALI
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
| | - Vildan KESGİN
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
| | - Taylan AKGÜN
- SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL BAŞAKŞEHİR ÇAM VE SAKURA ŞEHİR SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, KARDİYOLOJİ ANABİLİM DALI
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17
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Wilson AMMM, Almeida GSMD, Santos BDCFD, Nakahara-Melo M, Conceição APD, Cruz DDALMD. Factors associated with caregivers' contribution to self-care in heart failure. Rev Lat Am Enfermagem 2022; 30:e3632. [PMID: 35976358 DOI: 10.1590/1518-8345.5838.3632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/26/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to analyze the caregiver's contribution to self-care in heart failure and the predictor variables of this contribution. METHOD a cross-sectional descriptive and analytical study, with the participation of 140 dyads (patients and caregivers). The contribution to self-care was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index. Caregivers and patients were interviewed separately to obtain the data. Multiple linear regressions were used to verify predictor variables of caregiver contribution. RESULTS the mean score for contribution to maintenance self-care was 62.7 (SD=7.1), for management, 62.9 (SD=20.4) and for confidence was 63.3 (SD=22.1). The variables number of patient's medications, caregiver being related to the patient, social perception of caregiver, health-related quality of life of the patient and caregiver's confidence in contributing to self-care were predictors of caregiver's contribution to maintenance or management self-care. CONCLUSION the caregiver's contribution was insufficient. The social support perceived by the caregiver, the type of relationship the caregiver to the patient, the number of medications used by the patient, as well as the caregiver's confidence in contributing to self-care are variables that should be considered to assess the risk of insufficient contribution of the caregiver.
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Affiliation(s)
| | - Glauber Silva Mendes de Almeida
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil.,Universitatsklinikum Duesseldorf, Kardiochirurgie, Duesseldorf, NRW, Alemanha
| | - Bruna de Cassia Ferreira Dos Santos
- Hospital Municipal Dr Moysés Deutsch, Pronto-Socorro, São Paulo, SP, Brasil.,Universidade Federal de Juiz de Fora, Departamento de Enfermagem Aplicada, Juiz de Fora, MG, Brasil
| | - Michele Nakahara-Melo
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil.,Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | - Ana Paula da Conceição
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil.,Instituto Dante Pazzanese de Cardiologia, Unidade de Internação Adulto, São Paulo, SP, Brasil
| | - Diná de Almeida Lopes Monteiro da Cruz
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brasil.,Bolsista do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brasil
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18
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Schutz SE, Walthall HE. What are the needs and experiences of caregivers of people with heart failure? A qualitative study. Heart Lung 2022; 54:42-48. [PMID: 35339892 DOI: 10.1016/j.hrtlng.2022.03.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND The global burden of heart failure is estimated to be around 64 million people, with many needing care and support for daily living activities. These needs are usually filled by close relatives, often a spouse, and therefore someone of a similar age to the person for whom they care. OBJECTIVES The aim of this study was to explore the needs and experiences of caregivers caring for a person with heart failure through a qualitative interview approach. METHODS A qualitative study was conducted in a large region in South England. 17 caregivers were interviewed using a semi-structured approach and the data analysed using thematic analysis. RESULTS Four themes were identified from the data: a) Taking on the role of caregiver with the sub-themes of: acceptance and life changes; b) Getting to grips with being a caregiver with sub-themes: carrying out the care and coping with the care; c) Impact on own health and wellbeing: sub-themes of physical health and mental and emotional health and finally: d) Need for information and Support with sub-themes: trying to get knowledge and making sense. CONCLUSIONS This study has shown that heart failure caregiving can have a negative impact on caregivers' own health and wellbeing and involves complex care delivery for which they receive little support. Caregivers of people with heart failure report having significant information needs in order to understand the reasons for the care they provide yet feel marginalised by health care professionals.
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Affiliation(s)
- S E Schutz
- Senior Lecturer, Oxford Brookes University, Faculty of Health and Life Sciences, Oxford School of Nursing and Midwifery, Jack Straws Lane, Oxford, United Kingdom OX3 0FL, UK.
| | - H E Walthall
- Director of Nursing and Midwifery Research and Innovation, Oxford University Hospitals Foundation NHS Trust, Oxford and Oxford Biomedical Research Centre. OX3 9DU, United Kingdom
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19
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Goldfarb MJ, Bechtel C, Capers Q, de Velasco A, Dodson JA, Jackson JL, Kitko L, Piña IL, Rayner-Hartley E, Wenger NK, Gulati M. Engaging Families in Adult Cardiovascular Care: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2022; 11:e025859. [PMID: 35446109 PMCID: PMC9238560 DOI: 10.1161/jaha.122.025859] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Family engagement empowers family members to become active partners in care delivery. Family members increasingly expect and wish to participate in care and be involved in the decision-making process. The goal of engaging families in care is to improve the care experience to achieve better outcomes for both patients and family members. There is emerging evidence that engaging family members in care improves person- and family-important outcomes. Engaging families in adult cardiovascular care involves a paradigm shift in the current organization and delivery of both acute and chronic cardiac care. Many cardiovascular health care professionals have limited awareness of the role and potential benefits of family engagement in care. Additionally, many fail to identify opportunities to engage family members. There is currently little guidance on family engagement in any aspect of cardiovascular care. The objective of this statement is to inform health care professionals and stakeholders about the importance of family engagement in cardiovascular care. This scientific statement will describe the rationale for engaging families in adult cardiovascular care, outline opportunities and challenges, highlight knowledge gaps, and provide suggestions to cardiovascular clinicians on how to integrate family members into the health care team.
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20
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Bratches RWR, Freundlich NZ, Dionne-Odom JN, O'Malley AJ, Barr PJ. Perceptions of the impact of COVID-19 on healthcare communication in a nationally representative cross-sectional survey of family caregivers. BMJ Open 2022; 12:e051154. [PMID: 35418422 PMCID: PMC9016173 DOI: 10.1136/bmjopen-2021-051154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To understand the perceptions of the impact of the COVID-19 pandemic on healthcare communication with family caregivers. DESIGN Nationally representative survey. SETTING USA (national). PARTICIPANTS 340 family caregivers, demographically representative of the US population by race/ethnicity. PRIMARY OUTCOME MEASURES Communication outcomes (feeling involved by the provider, feeling involved by the care recipient, feeling more encouraged to be involved in care, feeling contributory to discussions, feeling questions are being answered), behavioural/wellness outcomes (feeling anxious, feeling isolated, feeling it is easier to attend the clinic visit), and desire to continue using telemedicine. RESULTS Having less than a college degree was associated with decreased odds of feeling involved by the provider (OR 0.46; 95% CI 0.26 to 0.83; p=0.01), feeling involved by the care recipient (OR 0.44; 95% CI 0.24 to 0.79; p=0.01), feeling more encouraged to be involved in care (OR 0.49; 95% CI 0.27 to 0.86; p=0.01), feeling like they contribute to discussions (OR 0.45; 95% CI 0.25 to 0.82; p=0.01) and feeling like their questions are being answered (OR 0.33; 95% CI 0.18 to 0.60; p<0.001). CONCLUSION In our sample, the shift to telemedicine during COVID-19 was well received but caregivers of low educational attainment reported poorer health communication, and a greater proportion of black/African American and Hispanic caregivers reported a desire to return to in-person visits. There is an opportunity to improve health systems and increase equity as telemedicine becomes more widespread.
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Affiliation(s)
- Reed W R Bratches
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | | | | | - A James O'Malley
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Paul J Barr
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
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21
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Antonio-Oriola R, Vellone E, Durante A, De Maria M, Di Nitto M, Gea-Caballero V, Santolalla-Arnedo I, Czapla M, Benavent-Cervera JV, Sánchez-González JL, Juárez-Vela R. Spanish Version of the Caregiver Contribution to Self-Care of Heart Failure Index (CC-SCHFI): A Psychometric Evaluation. J Pers Med 2022; 12:625. [PMID: 35455741 PMCID: PMC9028340 DOI: 10.3390/jpm12040625] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The Caregiver Contribution to Self-Care of Heart Failure (CC-SCHFI) is a theoretically driven instrument to measure the extent to which caregivers support heart failure (HF) patients to perform self-care. The CC-SCHFI measures caregivers' contribution to self-care maintenance and self-care management and caregiver confidence in contributing to heart failure patients' self-care. To date, the CC-SCHFI has never been tested in Spanish-speaking populations. PURPOSE To translate the CC-SCHFI from English into Spanish and to test its psychometric characteristics. METHOD CC-SCHFI translation and back-translation were performed according to the Beaton et al. methodology. Data from a cross-sectional study conducted in an outpatient clinic in Spain were used for the analysis. Psychometric analysis was performed with exploratory factor analysis (EFA) with oblique rotation. RESULTS Caregivers had a mean age of 60.5 years (SD 14,9) and the majority were female (85%). Data from 220 caregivers were analyzed. From EFA, using the principal axis factoring method, we extracted two factors in the self-care maintenance subscale ("treatment adherence behaviors" and "symptom control and maintenance behaviors"), two in the self-care monitoring subscale ("illness behaviors" and "prevention behaviors") and one factor for the self-efficacy subscale. The Pearson's rank correlation coefficients between SCHFI and CCSCHFI showed significant correlation in each subdimension.
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Affiliation(s)
- Rosa Antonio-Oriola
- Doctorate Program in Clinical and Community Nursing, University of Valencia, 46001 Valencia, Spain;
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Roma Tor Vergata, 00133 Rome, Italy; (E.V.); (M.D.M.)
| | - Angela Durante
- Group of Research in Care GRUPAC, Department of Nursing, University of La Rioja, 26004 Logroño, Spain; (I.S.-A.); (M.C.); (R.J.-V.)
| | - Maddalena De Maria
- Department of Biomedicine and Prevention, University of Roma Tor Vergata, 00133 Rome, Italy; (E.V.); (M.D.M.)
| | - Marco Di Nitto
- Centro per l’Eccellenza Clinica, la Qualità e la Sicurezza Delle Cure (CNEC), Istituto Superiore di Sanità, 00162 Rome, Italy;
| | - Vicente Gea-Caballero
- Faculty of Health Sciences, Valencia International University, 46002 Valencia, Spain; (V.G.-C.); (J.V.B.-C.)
| | - Iván Santolalla-Arnedo
- Group of Research in Care GRUPAC, Department of Nursing, University of La Rioja, 26004 Logroño, Spain; (I.S.-A.); (M.C.); (R.J.-V.)
| | - Michał Czapla
- Group of Research in Care GRUPAC, Department of Nursing, University of La Rioja, 26004 Logroño, Spain; (I.S.-A.); (M.C.); (R.J.-V.)
- Laboratory for Experimental Medicine and Innovative Technologies, Department of Emergency Medical Service, Wroclaw Medical University, 51-616 Wroclaw, Poland
| | | | | | - Raúl Juárez-Vela
- Group of Research in Care GRUPAC, Department of Nursing, University of La Rioja, 26004 Logroño, Spain; (I.S.-A.); (M.C.); (R.J.-V.)
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Wilson AMMM, Almeida GSMD, Santos BDCFD, Nakahara-Melo M, Conceição APD, Cruz DDALMD. Factores asociados a la contribución de los cuidadores para el autocuidado de la insuficiencia cardiaca. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5838.3634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumen Objetivo: analizar la contribución del cuidador para el autocuidado en la insuficiencia cardiaca y las variables predictoras de esa contribución. Método: estudio transversal descriptivo y analítico, con la participación de 140 díadas (pacientes y cuidadores). La contribución para el autocuidado fue evaluada por medio del Caregiver Contribution to Self-Care of Heart Failure Index. Los cuidadores y pacientes fueron entrevistados separadamente para obtención de los datos. La regresión linear múltiple fue utilizada para verificar variables predictoras de la contribución del cuidador. Resultados: la puntuación media de contribución para el autocuidado de manutención fue 62,7 (DE=7,1), de administración fue 62,9 (DE=20,4) y de confianza fue 63,3 (DE=22,1). Las variables: número de medicamentos del paciente, cuidador tener parentesco con el paciente, percepción social del cuidador, calidad de vida relacionada a la salud del paciente y la confianza del cuidador en la contribución para el autocuidado, fueron predictoras de la contribución del cuidador para el autocuidado de manutención o de administración. Conclusión: la contribución del cuidador fue insuficiente. El apoyo social percibido por el cuidador, el cuidador tener o no parentesco con el paciente, el número de medicamentos utilizados por el paciente y la confianza del cuidador en contribuir para el autocuidado, son variables que deben ser consideradas para evaluar el riesgo de contribución insuficiente del cuidador.
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Affiliation(s)
| | | | | | - Michele Nakahara-Melo
- Universidade de São Paulo, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
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23
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The Influence of Preparedness, Mutuality, and Self-efficacy on Home Care Workers' Contribution to Self-care in Heart Failure: A Structural Equation Modeling Analysis. J Cardiovasc Nurs 2022; 37:146-157. [PMID: 33315614 PMCID: PMC8196074 DOI: 10.1097/jcn.0000000000000768] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Home care workers (HCWs) are increasingly caring for patients with heart failure (HF). Previous studies have shown that they contribute to HF patients' care, but how their preparedness and their relationship with patients (mutuality) influence caregiving is unknown, as well as the role of HCWs' self-efficacy. OBJECTIVE Guided by the Situation-Specific Theory of Caregiver Contribution to HF Self-Care, we investigated the influence of HCWs' preparedness and mutuality on HCWs' contribution to HF self-care and the mediating effect of HCWs' self-efficacy in the process. METHODS We conducted a cross-sectional survey of HCWs who cared for patients with HF. The survey included the Caregiver Preparedness Scale, Mutuality Scale, Caregiver Contribution to Self-Care of HF Index, and Caregiver Self-Efficacy in Contributing to Self-Care Scale. We performed structural equation modeling and a mediation analysis. RESULTS A total of 317 HCWs employed by 22 unique home care agencies across New York, NY, completed the survey. They had a median age of 50 years, 94% were women, and 44% were non-Hispanic Black. Results demonstrated that mutuality had a direct influence on HCW contribution to self-care and preparedness influenced their contribution to self-care, but only through the mediation of self-efficacy. CONCLUSION Home care workers' preparedness, mutuality, and self-efficacy have important roles in influencing their contribution to HF self-care. As a workforce increasingly involved in the care of patients with HF, knowing the mechanisms underpinning HCWs' contribution to self-care may illuminate future interventions aimed at improving their contributions and HF patient outcomes.
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Wilson AMMM, Almeida GSMD, Santos BDCFD, Nakahara-Melo M, Conceição APD, Cruz DDALMD. Factors associated with caregivers’ contribution to self-care in heart failure. Rev Lat Am Enfermagem 2022. [PMID: 35976358 PMCID: PMC9364777 DOI: 10.1590/1518-8345.5838.3633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: to analyze the caregiver’s contribution to self-care in heart failure and the predictor variables of this contribution. Method: a cross-sectional descriptive and analytical study, with the participation of 140 dyads (patients and caregivers). The contribution to self-care was assessed using the Caregiver Contribution to Self-Care of Heart Failure Index. Caregivers and patients were interviewed separately to obtain the data. Multiple linear regressions were used to verify predictor variables of caregiver contribution. Results: the mean score for contribution to maintenance self-care was 62.7 (SD=7.1), for management, 62.9 (SD=20.4) and for confidence was 63.3 (SD=22.1). The variables number of patient’s medications, caregiver being related to the patient, social perception of caregiver, health-related quality of life of the patient and caregiver’s confidence in contributing to self-care were predictors of caregiver’s contribution to maintenance or management self-care. Conclusion: the caregiver’s contribution was insufficient. The social support perceived by the caregiver, the type of relationship the caregiver to the patient, the number of medications used by the patient, as well as the caregiver’s confidence in contributing to self-care are variables that should be considered to assess the risk of insufficient contribution of the caregiver.
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Affiliation(s)
| | | | | | - Michele Nakahara-Melo
- Universidade de São Paulo, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
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Wawrziczny E, Antoine P, Doba K. Modeling the Distress of Adult-Child Caregivers of People with Dementia: The Mediating Role of Self-Efficacy. J Alzheimers Dis 2021; 84:855-867. [PMID: 34602477 DOI: 10.3233/jad-210624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The increased tasks and responsibilities involved in supporting a parent with dementia (PWD) can induce distress in adult-child caregivers. Previous studies have shown that distress can be influenced by PWD and caregiver determinants, but few studies have considered the associations between these variables. OBJECTIVE This study tested a complex model of adult-child caregiver distress in which PWD and caregiver determinants and their associations are considered. METHODS 159 adult-child caregivers participated in this online study. PWD and caregiver determinants were assessed using questionnaires and their associations were investigated using the partial least squares path method. RESULTS The model showed a significant partial mediation through self-efficacy (confidence in one's ability to organize and manage caregiving situations) between poor self-rated health and distress. Self-efficacy was a significant mediator of the relationship between informal social support and distress, and between preparedness and distress. The direct path between parental overprotection and distress was significant. The association between care and distress was significantly stronger for adult-child caregivers not living with their PWD. CONCLUSION The model revealed the important mediating role of self-efficacy. Clinical interventions should improve the preparedness of adult-child caregivers and the quality of social support. The positive perception of their self-rated health may thus be promoted.
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Affiliation(s)
- Emilie Wawrziczny
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d'Ascq, France
| | - Pascal Antoine
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d'Ascq, France
| | - Karyn Doba
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d'Ascq, France
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Durante A, De Maria M, Boyne J, Jaarsma T, Juarez-Vela R, Strömberg A, Vellone E. Development and psychometric testing of the European Heart Failure Self-Care behaviour scale caregiver version (EHFScB-C). PATIENT EDUCATION AND COUNSELING 2021; 104:2106-2111. [PMID: 33516593 DOI: 10.1016/j.pec.2021.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 01/10/2021] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The European Heart Failure Self-Care Behaviour Scale (EHFScBS) is used worldwide to measure heart failure (HF) patient self-care, but a caregiver version does not exist. OBJECTIVE To develop and test the European HF Self-Care Behaviour Scale for Caregivers (EHFScBS-C) in a population of informal caregivers of HF patients. METHODS The EHFScBS-C was derived from the EHFScBS to measure the extent to which caregivers contribute to HF patient self-care. The EHFScBS-C was developed in English and then translated into Italian, Spanish and Dutch, after which it was back-translated. EHFScBS-C data were collected from 193 HF caregivers enrolled in Italy, Spain and the Netherlands. RESULTS Exploratory factor analysis revealed two factors with supportive fit indices (CFI = 0.990; RMSEA = 0.048): caregivers' contributions to HF self-care related to medical issues, and caregivers' contributions related to lifestyle. Internal consistency reliability was supported as well (Cronbach's alpha 0.90 for the overall scale). Construct validity was demonstrated with significant correlations with the Caregiver Preparedness Scale. CONCLUSION AND PRACTICE IMPLICATIONS The EHFScBS-C has adequate validity and reliability for its use in clinical practice and research to measure the extent to which caregivers contribute to HF patient self-care. The EHFScBS-C can be used in combination with the EHFScBS to conduct dyadic studies.
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Affiliation(s)
- Angela Durante
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
| | - Maddalena De Maria
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Josiane Boyne
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Division of Nursing, Linköping University, Linköping, Sweden
| | | | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences, Division of Nursing, Linköping University, Linköping, Sweden; Department of Cardiology, Linköping University, Linköping, Sweden
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
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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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Longitudinal family caregiving experiences in heart failure: Secondary qualitative analysis of interviews. Heart Lung 2021; 50:627-633. [PMID: 34091108 DOI: 10.1016/j.hrtlng.2021.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/09/2021] [Accepted: 05/11/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Considering the potential impacts of family caregivers on heart failure management and the costs of healthcare, health professionals need to pay attention to the challenges faced by family caregivers. OBJECTIVE This study longitudinally explored the caregiving experiences of family caregivers of persons with heart failure. METHODS Serial interview scripts collected from 53 family caregivers were analyzed using a content analysis method. RESULTS The following themes emerged: (1) accumulating knowledge and skills for caregiving; (2) losing a sense of control; (3) balancing an unstable life; (4) constructing illness memory; (5) centering the patient in daily life; (6) accepting the loss of a family member; (7) coping with grief by drawing on social support; (8) facing financial responsibility; and (9) rethinking hospice care. CONCLUSION Family caregivers experience concern about unpredictable caregiving years, disease's fluctuating symptoms and poor prognosis. More educational opportunities, financial counseling programs, and palliative care consultations should be provided.
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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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Abstract
OBJECTIVE Family-centered health care requires successful communication between patient, family caregivers, and healthcare providers. Among all providers, physicians are most likely to interact with caregivers. Using the Family Caregiver Communication Typology, this study examined perceived communication self-efficacy with physicians among four types of caregivers: Manager, Partner, Carrier, and Lone. METHOD A cross-sectional online survey included the Family Communication Typology Tool, Communication Perceived Self-Efficacy Scale, the Caregiver Quality of Life-Revised Index, and the Generalized Anxiety Disorder (GAD-2) questionnaire. RESULTS An online survey of 220 family caregivers currently caring for an adult family member revealed significant differences in communication self-efficacy among family caregiver communication types, revealing that Partner caregivers have the highest perceived communication self-efficacy, and that for some caregiver types, higher perceived communication self-efficacy is associated with certain quality of life dimensions. SIGNIFICANCE OF RESULTS Differences in communication self-efficacy with physicians among the four caregiver communication types (Manager, Partner, Carrier, and Lone) provide further evidence that the typology represents variance in caregiver communication abilities. Development of future medical curricula targeting communication skill training should include an overview of the typology and communication strategies as these may increase effective communication between physicians and caregivers.
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