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Yu DSF, Qiu C, Li PWC, Lau J, Riegel B. Effects of dyadic care interventions for heart failure on patients' and caregivers' outcomes: A systematic review, meta-analysis and meta-regression. Int J Nurs Stud 2024; 157:104829. [PMID: 38901123 DOI: 10.1016/j.ijnurstu.2024.104829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 05/25/2024] [Accepted: 05/29/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND The contemporary model for managing heart failure has been extended to a patient-family caregiver dyadic context. However, the key characteristics of the model that can optimise health outcomes for both patients and caregivers remain to be investigated. OBJECTIVES This study aimed to identify the effects of dyadic care interventions on the behavioural, health, and health-service utilisation outcomes of patients with heart failure and their family caregivers and to explore how the intervention design characteristics influence these outcomes. DESIGN This study involved systematic review, meta-analysis, and meta-regression techniques. METHODS We performed a systematic review and meta-analysis, using 12 databases to identify randomised controlled trials or quasi-experimental studies published in English or Chinese between database inception and 31 December 2022. The considered interventions included those targeting patients with heart failure and their family caregivers to enhance disease management. Data synthesis was performed on various patient- and caregiver-related outcomes. The identified interventions were categorised according to their design characteristics for subgroup analysis. Meta-regression was performed to explore the relationship between care delivery methods and their effectiveness. RESULTS We identified 48 studies representing 9171 patient-caregiver dyads. Meta-analyses suggested the positive effects of dyadic care interventions on patients' health outcomes [Hedges' g (95 % confidence interval {CI}): heart failure knowledge = 1.0 (0.26, 1.75), p = 0.008; self-care confidence = 0.45 (0.08, 0.83), p = 0.02; self-care maintenance = 1.12 (0.55, 1.70), p < 0.001; self-care management = 1.01 (0.54, 1.49), p < 0.001; anxiety = -0.18 (-0.34, -0.02), p = 0.03; health-related quality of life = 0.30 (0.08, 0.51), p < 0.001; hospital admission (risk ratio {95 % CI}: hospital admission = 0.79 (0.65, 0.97), p = 0.007; and mortality = 0.58 (0.36, 0.93), p = 0.02)]. Dyadic care interventions also improved the caregivers' outcomes [Hedges' g (95 % CI): social support = 0.67 (0.01, 1.32), p = 0.05; perceived burden = -1.43 (-2.27, -0.59), p < 0.001]. Although the design of the identified care interventions was heterogeneous, the core care components included enabling and motivational strategies to improve self-care, measures to promote collaborative coping within the care dyads, and nurse-caregiver collaborative practice. Incorporating the first two core components appeared to enhance the behavioural and health outcomes of the patients, and the addition of the last component reduced readmission. Interventions that engaged both patients and caregivers in care provision, offered access to nurses, and optimised continuity of care led to better patient outcomes. CONCLUSIONS These findings demonstrate that dyadic care interventions can effectively improve disease management in a family context, resulting in better health outcomes for both patients and caregivers. Additionally, this study provides important insights into the more-effective design characteristics of these interventions. REGISTRATION NUMBER The review protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews (CRD42022322492).
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Affiliation(s)
- Doris Sau-Fung Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China.
| | - Chen Qiu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China.
| | - Polly Wai Chi Li
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China.
| | - Jason Lau
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region of China.
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Joshi VL, Taylor RS. Measuring care dependency in heart failure. Eur J Cardiovasc Nurs 2024; 23:e77-e78. [PMID: 38243608 DOI: 10.1093/eurjcn/zvad141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/21/2024]
Affiliation(s)
- Vicky L Joshi
- Department of Physiotherapy and Paramedicine, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Fang W, Chen C, Zhang X, Li J, Li X, Fan X. Association Between Benefit Finding and Self-care Management in Heart Failure Patient-Caregiver Dyads: The Mediating Role of Mutuality. J Cardiovasc Nurs 2024; 39:E93-E102. [PMID: 37563755 DOI: 10.1097/jcn.0000000000001034] [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: 08/12/2023]
Abstract
BACKGROUND Inadequate self-care management has been reported in patients with heart failure (HF) and their family caregivers. However, evidence on the influencing factors and corresponding action paths for self-care management within a dyadic context is limited. OBJECTIVE The aim of this study was to examine dyadic associations between benefit finding and self-care management in HF patient-caregiver dyads and the mediating role of mutuality in these associations. METHODS This cross-sectional study was conducted in China, and a convenience sample of 253 HF patient-caregiver dyads was included in the analysis. Dyadic benefit finding and mutuality, patients' self-care management, and caregivers' contributions to self-care management were measured using self-reported questionnaires. The actor-partner interdependence model and actor-partner interdependence mediation model were adopted to analyze the data. RESULTS Patients' benefit finding had an actor effect on their own self-care management (β = 0.134, P < .05) and a partner effect on caregivers' contributions to self-care management (β = 0.130, P < .05). Similarly, caregivers' benefit finding had an actor effect on their contributions to self-care management (β = 0.316, P < .01) and a partner effect on patients' self-care management (β = 0.187, P < .01). Moreover, patients' mutuality completely mediated the actor effect of their benefit finding on self-care management (β = 0.127; 95% confidence interval, 0.032-0.233), and caregivers' mutuality partially mediated the actor effect of their benefit finding on contributions to self-care management (β = 0.060; 95% confidence interval, 0.012-0.124). In addition, caregivers' mutuality completely mediated the partner effect of patients' benefit finding on caregivers' contributions to self-care management (β = 0.036; 95% confidence interval, 0.009-0.081). CONCLUSIONS The findings revealed the importance of benefit finding and mutuality, 2 modifiable factors positively associated with dyadic HF self-care management. Dyadic interventions targeting on enhancing benefit finding and mutuality should be designed and implemented to improve HF self-care management.
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Prevalence of Postoperative Atrial Fibrillation and Impact to Nursing Practice—A Cross Sectional Study. Med Sci (Basel) 2023; 11:medsci11010022. [PMID: 36976530 PMCID: PMC10056994 DOI: 10.3390/medsci11010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Background: Atrial fibrillation is the most common clinically significant cardiac arrhythmia, and it might lead to heart failure, which prolongs the duration of hospitalization and consequently increases the cost of treatment. Thus, diagnosing and treating atrial fibrillation should be the first line of defense against further complications. This study aimed to determine the incidence rate of postoperative atrial fibrillation and correlation with cardiac surgery on heart valves. A specific aim was to determine the relationship between the prevalence of atrial fibrillation and socio-demographic features. Methods: The study has a prospective cross-sectional design. The questionnaire was anonymous, requesting socio-demographic information as inclusion criteria, and the data were analyzed using descriptive statistics methods. Results: The sample was 201 patients. χ2 test and t-test were performed where we found that the frequency of atrial fibrillation was higher in the groups that have had valve surgery compared to other cardiac surgeries (χ2 = 7.695, ss = 2, p = 0.021). Atrial fibrillation increased with the age of the patients, but the prevalence of atrial fibrillation was not correlated with body weight. Conclusion: The results of this this study show that atrial fibrillation was higher in the participants who had valve surgery compared to other cardiac surgeries. There was also an increase in atrial fibrillation in the older participants. The results of this study can help to improve nursing practice and the quality of care for cardiac surgery patients with regard to daily activities, or planning nursing care due to the patient’s condition.
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Shamali M, Shahriari M, Konradsen H, Akbari M, Afshari Z, Abbasinia M, Østergaard B. CROSS-CULTURAL ADAPTATION AND VALIDATION OF THE PERSIAN VERSION OF THE FAMILY FUNCTIONING, HEALTH, AND SOCIAL SUPPORT QUESTIONNAIRE IN A SAMPLE OF HEART FAILURE PATIENTS AND THEIR FAMILY MEMBERS. J Nurs Meas 2023; 31:30-43. [PMID: 35725025 DOI: 10.1891/jnm-2021-0018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and Purpose: Family functioning, family health, and social support have significant roles in the management of heart failure (HF). This study aimed to translate, adapt, and assess the validity and reliability of the Persian version of the Family Functioning, Family Health, and Social Support (FAFHES) questionnaire. Methods: FAFHES questionnaire was translated into Persian, and an expert panel assessed the cross-cultural adaptation. We examined the construct validity by confirmatory factor analysis and internal consistency by Cronbach's alpha coefficients among 576 participants. Results: The Persian FAFHES confirmed the three-factor structure in the social support and the five-factor structure in the family health scales. However, the family functioning scale yielded the three-factor structure versus the four-factor structure in the original scales. The Cronbach's alpha for the three scales varied from 0.85 to 0.94. Conclusions: The adapted FAFHES seems to be valid and reliable to measure family functioning, family health, and social support in families with HF.
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Affiliation(s)
- Mahdi Shamali
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mohsen Shahriari
- Nursing and Midwifery Care Research Center, Adult Health Medical Surgical Care Nursing Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hanne Konradsen
- Department of Gastroenterology, Herlev and Gentofte University Hospital, Copenhagen, Denmark
| | - Mohammad Akbari
- Department of Psychiatric Mental Health Nursing, Isfahan University of Medical Sciences, Isfahan, Iran
- Chamran Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Afshari
- Department of Prosthodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Birte Østergaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Méndez-Bailon M, Lorenzo-Villalba N, Rubio-Garcia J, Moreno-García MC, Ropero-Luis G, Martínez-Litago E, Quirós-López R, Carrascosa-García S, González-Franco A, Andrès E, Casado-Cerrada J, Montero-Pérez-Barquero M. Clinical Characteristics and Prognostic Relevance of Different Types of Caregivers for Elderly Patients with Acute Heart Failure-Analysis from the RICA Registry. J Clin Med 2022; 11:3516. [PMID: 35743586 PMCID: PMC9225050 DOI: 10.3390/jcm11123516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/08/2022] [Accepted: 06/16/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Patients with heart failure encompass a heterogeneous group, but they are mostly elderly patients with a large burden of comorbid conditions. Objective: The aim of this study was to compare the clinical characteristics and the prognostic impact on hospital admissions and mortality in a population of patients with HF with different types of caregivers (family members, professionals, and the patient himself). Methods: We conducted an observational study from a prospective registry. Patients from the National Registry of Heart Failure (RICA), which belongs to the Working Group on Heart Failure and Atrial Fibrillation of the Spanish Society of Internal Medicine (SEMI), were included. Patients with heart failure were classified, according to the type of main caregiver, into four groups: the patient himself/herself, a partner, children, or a professional caregiver. A bivariable analysis was performed between the clinical, analytical, therapeutic, and prognostic characteristics of the different groups. The endpoints of the study were all-cause mortality at 1 year; mortality at 120 days; and the readmission rate for HF at 30 days, 120 days, and 1 year of follow-up. In all cases, the level of statistical significance was set at p < 0.05. Results: A total of 2147 patients were enrolled in this study; women represented 52.4%, and the mean age was 81 years. The partner was the caregiver for 703 patients, children were caregivers for 1097 patients, 199 patients had a professional caregiver, and only 148 patients were their own caregivers. Women were more frequently cared for by their children (65.8%) or a professional caregiver (61.8%); men were more frequently cared for by their spouses (68.7%) and more frequently served as their own caregivers (59.5%) (p < 0.001). No statistically significant differences were observed in relation to readmissions or mortality at one year of follow-up between the different groups. A lower probability of readmission and death was observed for patients who received care from a partner or children/relative, with log-rank scores of 11.2 with p= 0.010 and 10.8 with p = 0.013. Conclusions: Our study showed that the presence of a family caregiver for elderly patients with heart failure was associated with a lower readmission rate and a lower mortality rate at 120 days of follow-up. Our study also demonstrated that elderly patients with good cognitive and functional status can be their own caregivers, as they obtained good health outcomes in terms of readmission and mortality. More prospective studies and clinical trials are needed to evaluate the impact of different types of caregivers on the outcomes of patients with heart failure.
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Affiliation(s)
- Manuel Méndez-Bailon
- Internal Medicine Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Universidad Complutense, 28040 Madrid, Spain;
| | - Noel Lorenzo-Villalba
- Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France;
| | - Jorge Rubio-Garcia
- Internal Medicine Department, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain;
| | | | - Guillermo Ropero-Luis
- Internal Medicine Department, Hospital de la Serranía de Ronda, 29400 Malaga, Spain;
| | | | - Raúl Quirós-López
- Internal Medicine Department, Hospital Costa del Sol, 29603 Málaga, Spain;
| | - Sara Carrascosa-García
- Internal Medicine Department, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain;
| | - Alvaro González-Franco
- Internal Medicine Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain;
| | - Emmanuel Andrès
- Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France;
| | - Jesús Casado-Cerrada
- Internal Medicine Department, Hospital Universitario de Getafe, 28905 Madrid, Spain;
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Suksatan W, Tankumpuan T, Davidson PM. Heart Failure Caregiver Burden and Outcomes: A Systematic Review. J Prim Care Community Health 2022; 13:21501319221112584. [PMID: 35938489 PMCID: PMC9364181 DOI: 10.1177/21501319221112584] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction/Objective: This review aimed to summarize articles describing caregiver burden and the
relationship between health outcomes as well as describing interventions
focusing on this population. Methods: The review used the PRISMA statement and Whittemore and Knafl guidelines. The
search engines Scopus, PubMed, Ovid (PsycINFO), and CINAHL were searched for
articles published in English. Results: This review included 30 studies that met the criteria. Physical,
psychological, and social factors were associated with HF caregiver burden.
HF caregiver interventions included health education, post-discharge home
visits, phone calls, counseling, and support groups that demonstrated some
potential to reduce the caregivers’ burden. Discussion: Healthcare provider team should screen for caregiver burden and promote
healthy behaviors, and strategies to improve quality of life. Further
studies should include caregivers as care team members and embed social
networking in the interventions for reducing HF caregiver burden. The
caregivers’ burden could influence the poor outcomes of care, including
physical, psychological, societal, and functional dimensions. Future
interventions should develop to alleviate HF caregiver burden.
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Affiliation(s)
- Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand.,Trudy Busch-Valentine School of Nursing, Saint Louis University, Saint Louis, MO, USA
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