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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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Piamjariyakul U, Smothers A, Wang K, Shafique S, Wen S, Petitte T, Young S, Sokos G, Smith CE. Palliative care for patients with heart failure and family caregivers in rural Appalachia: a randomized controlled trial. BMC Palliat Care 2024; 23:199. [PMID: 39097733 DOI: 10.1186/s12904-024-01531-2] [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] [Received: 05/23/2024] [Accepted: 07/29/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND Heart failure (HF) is a debilitating disease with worsening symptoms and family caregiving burden. HF affects more than 8 million Americans. West Virginia has the highest HF death rate in the U.S. and limited healthcare services. This study tested whether the family HF palliative and end-of-life care intervention (FamPALcare) improved patient and caregiver outcomes at 3- and 6-month study endpoints. METHODS This study used a randomized controlled trial design. Patients with HF and their caregivers were randomly assigned together to the intervention (n = 21) or control (n = 18) group. The intervention included five telephone coaching sessions on the HF home, palliative, and end-of-life care. The outcome data collected at baseline and at 3 and 6 months were from the patients' (a) HF-related health status and depression/anxiety scale scores; and from caregivers' (b) caregiving burden and depression/anxiety scale scores; and (c) anonymous ratings on the 11-item FamPALcare helpfulness scale, completed by the intervention participants. RESULTS The mean age of the patients was 65.66 (SD = 13.72) years, and 67% were White males. The mean age of the caregivers was 62.05 (SD = 13.14) years, and 77% were White females. Compared to the controls, patients in the intervention group had significantly greater scores for HF-related health status (p < .05) and lower depression/anxiety scores at 6 months, the study endpoint. The family caregivers in the intervention group had significantly lower scores on caregiving burden (p < .05) and depression/anxiety (p < .01) at 3 months. The mean helpfulness rating was M = 4.46 out of 5 (SD = 0.49). CONCLUSIONS The FamPALcare intervention was found to be effective at improving patient HF-related health status and reducing caregiver burden and improving both patient and caregiver depression and anxiety scores. The FamPALcare HF intervention was found feasible and consistently delivered (fidelity). The FamPALcare intervention's cost-effectiveness and helpfulness ratings information will be used to plan for subsequent clinical trials. TRIAL REGISTRATION ClinicalTrials.gov NCT04153890, Registered on 4 November 2019, https://clinicaltrials.gov/ct2/show/NCT04153890 .
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Affiliation(s)
| | - Angel Smothers
- West Virginia University School of Nursing, Morgantown, USA
| | - Kesheng Wang
- West Virginia University School of Nursing, Morgantown, USA
| | - Saima Shafique
- West Virginia University School of Nursing, Morgantown, USA
| | - Sijin Wen
- Department of Biostatistics School of Public Health, West Virginia University, Morgantown, USA
| | - Trisha Petitte
- West Virginia University School of Nursing, Morgantown, USA
| | | | - George Sokos
- West Virginia University Heart and Vascular Institute, J.W. Ruby Memorial Hospital, Morgantown, USA
| | - Carol E Smith
- School of Nursing, School of Preventive Medicine, University of Kansas Medical Center, Kansas City, USA
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3
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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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Wu Q, Pei H, Zhang L, Deng H, Chen Y, Wang L, He W, He J, Song C. Self-care challenges of patients with heart failure from the perspectives of patients and caregivers: A qualitative study. Geriatr Nurs 2024; 58:446-458. [PMID: 38909541 DOI: 10.1016/j.gerinurse.2024.06.005] [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: 02/28/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 06/25/2024]
Abstract
OBJECTIVE self-care is critically important for the long-term management of heart failure (HF) patients, with caregivers playing an important role in promoting self-care. However, adherence to self-care is typically low among HF patients worldwide. METHODS In-depth qualitative interviews were conducted with individuals diagnosed with HF. To structure the interview guide and underpin the analysis, two established behavioral science frameworks, the Behavior Change Wheel (BCW) and the Theoretical Domains Framework (TDF), were used in this study. RESULTS A total of 32 participants were included (n = 16 patients, n = 16 caregivers), with themes involving: barriers included: "Self-care with Limited Capability," "Insufficient External Support," "Lack of Motivation for Self-Care." Facilitators included: "Striving to Adapt to Disease Demands," "Adequate External Support," "Positive Health Behaviors and Experiences." CONCLUSIONS Providing positive support to heart failure patients and their caregivers, along with cultivating intrinsic motivation for behavioral change, can enhance self-care ability.
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Affiliation(s)
- Qiuping Wu
- Department of Cardiology, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Haoyu Pei
- Department of Anesthesiology, Army Medical Center of PLA, Chongqing 400042, China
| | - Limin Zhang
- Department of Cardiology, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Handan Deng
- Department of Cardiology, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Yulu Chen
- Department of Otolaryngology, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Lei Wang
- Department of Orthopedics, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Wei He
- Department of Gastroenterology, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Jing He
- Department of Hospital Infection Control, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China
| | - Caiping Song
- President Office, The Second Affiliated Hospital of Army Medical University, Chongqing 400037, China.
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Moreines LT, David D, Murali KP, Dickson VV, Brody A. The perspectives of older adults related to transcatheter aortic valve replacement: An integrative review. Heart Lung 2024; 68:23-36. [PMID: 38901178 DOI: 10.1016/j.hrtlng.2024.05.013] [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: 03/07/2024] [Revised: 05/10/2024] [Accepted: 05/31/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND Aortic Stenosis (AS) is a common syndrome in older adults wherein the narrowing of the aortic valve impedes blood flow, resulting in advanced heart failure.1 AS is associated with a high mortality rate (50 % at 6 months if left untreated), substantial symptom burden, and reduced quality of life.1-3 Transcatheter aortic valve replacement (TAVR) was approved in 2012 as a less invasive alternative to surgical valve repair, offering a treatment for older frail patients. Although objective outcomes have been widely reported,4 the perspectives of older adults undergoing the TAVR process have never been synthesized. OBJECTIVES To contextualize the perspectives and experiences of older adults undergoing TAVR. METHODS An integrative review was conducted using Whittemore and Knafl's five-stage methodology.5 Four electronic databases were searched in April 2023. Articles were included if a qualitative methodology was used to assess the perceptions of older adults (>65 years old) undergoing or recovering from TAVR. RESULTS Out of 4619 articles screened, 12 articles met the criteria, representing 353 individuals from 10 countries. Relevant themes included the need for an individualized care plan, caregiver and family support, communication and education, persistent psychosocial and physical symptoms, and the unique recovery journey. CONCLUSION Older adults with AS undergoing TAVR generally perceive their procedure positively. Improved interdisciplinary and holistic management, open communication, symptom assessment, support, and education is needed.
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Affiliation(s)
| | - Daniel David
- New York University Rory Meyers College of Nursing
| | | | | | - Abraham Brody
- New York University Rory Meyers College of Nursing; New York University Grossman School of Medicine
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Piamjariyakul U, Wang K, Smith M, Young S, Shafique S, Navia RO, Williams K. Family Caregiving of Patients With Heart Failure and Vascular Dementia in Rural Appalachia: A Mixed-Methods Study. West J Nurs Res 2024; 46:344-355. [PMID: 38551329 PMCID: PMC11182019 DOI: 10.1177/01939459241242536] [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: 04/13/2024]
Abstract
INTRODUCTION Vascular dementia and heart failure (HF) are common co-existing conditions among adult populations. Each condition requires extensive home caregiving from family caregivers, especially those in rural Appalachia. This study aimed to assess caregivers' burden and their physical and mental health status, as well as explore their experiences and needs. METHODS This study used an exploratory mixed-methods design combining quantitative and qualitative research (N = 20 caregivers). We collected data using questionnaires, short-answered interviews, and focus group discussions. The multivariable generalized linear model (GLiM) was used to analyze quantitative data; content analysis was used for qualitative data. RESULTS The average age of family caregivers was 64.95 years. The generalized linear model showed that the caregiving burden was associated with caregivers' depression/anxiety (r = 0.68, P < .001) and their number of dementia caregiving years (r = 0.54, P < .05). Caregivers' poor physical health status was associated with better preparedness for HF and dementia home caregiving (r = 0.52, P < .05) and male caregivers (r = -0.46, P < .01). Caregivers' mental health status was associated with depression/anxiety (r = -0.80, P < .001). The qualitative data identified key caregiving themes: emotional impact and physical demands of caregiving, lack of help in rural areas, dealing with multiple disease progression, and relationship changes with their loved ones. CONCLUSION Caregiving burden was associated with caregivers' home care responsibilities and the need for support. Nurse-led home caregiving preparedness interventions tailored for family caregivers of patients with HF and dementia in rural areas are recommended.
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Affiliation(s)
| | - Kesheng Wang
- School of Nursing, West Virginia University, Morgantown, WV, USA
| | - Marilyn Smith
- School of Nursing, West Virginia University, Morgantown, WV, USA
| | - Stephanie Young
- School of Nursing, West Virginia University, Morgantown, WV, USA
| | - Saima Shafique
- School of Nursing, West Virginia University, Morgantown, WV, USA
| | - R. Osvaldo Navia
- Department of Medicine, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, USA
| | - Kristine Williams
- School of Nursing, The University of Kansas Medical Center, Kansas City, KS, USA
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7
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Quattrone F, Aimo A, Zuccarino S, Morelli MS, Morfino P, Gioia A, Passino C, Ferrè F, Nuti S, Emdin M. Unmet needs in end-of-life care for heart failure patients. Int J Cardiol 2024; 399:131750. [PMID: 38216064 DOI: 10.1016/j.ijcard.2024.131750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 01/14/2024]
Abstract
OBJECTIVE To investigate end-of-life (EoL) care for heart failure (HF) in Tuscany (Italy) from healthcare professionals' perspective and identify areas for intervention. METHODS All the directors of Cardiology units (n = 29) and palliative care (PC) units (n = 14) in Tuscany were surveyed on the practices of EoL care. RESULTS Forty-five percent of cardiologists reported that their hospital had some EoL care services for HF patients. However, 75% did not have a multidisciplinary team providing EoL care for HF patients. Sixty-four percent stated that <25% of patients who might benefit from PC did receive it, and 18% stated that no patient received PC. For most of PC specialists, HF patients accounted for <25% of their patients. PC specialists believed that patients with cancer diseases were much more likely to receive PC than HF patients at EoL, and 36% judged that almost no HF patients were timely referred to hospice care. The majority of PC specialists reported that almost no HF patient prepared advance healthcare directives, as opposite to 57% for cancer patients, suggesting poor understanding or acceptance of their terminal condition. CONCLUSIONS The management of HF patients in the EoL stage in Tuscany is often suboptimal. EoL care should be implemented to ensure an adequate quality of life to these patients.
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Affiliation(s)
- Filippo Quattrone
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Alberto Aimo
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
| | - Sara Zuccarino
- Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Maria Sole Morelli
- Bioinformatica Traslazionale e e-Health, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Paolo Morfino
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Angela Gioia
- Hospice, UF Cure Palliative, Azienda USL Toscana Nord Ovest, Pisa, Italy
| | - Claudio Passino
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Francesca Ferrè
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Sabina Nuti
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Management and Healthcare Laboratory, Institute of Management and Department EMbeDS, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Michele Emdin
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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Grubic N, Amarasekera S, Mantella L, Stall NM. Heart of the Matter: The Physical and Mental Health Burden of Caregiving for Cardiovascular Patients. Can J Cardiol 2024; 40:351-354. [PMID: 38042336 DOI: 10.1016/j.cjca.2023.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 11/28/2023] [Indexed: 12/04/2023] Open
Affiliation(s)
- Nicholas Grubic
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - Sonali Amarasekera
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Laura Mantella
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nathan M Stall
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of General Internal Medicine and Geriatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
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Rapelli G, Donato S, Giusti EM, Pietrabissa G, Parise M, Pagani AF, Spatola CAM, Bertoni A, Castelnuovo G. Recognizing and Appreciating the Partner's Support Protects Relationship Satisfaction during Cardiac Illness. J Clin Med 2024; 13:1180. [PMID: 38398491 PMCID: PMC10890017 DOI: 10.3390/jcm13041180] [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: 12/22/2023] [Revised: 02/05/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND This study aimed to examine whether dyadic coping (DC) is associated with relationship satisfaction (RS) among couples facing cardiac diseases. Furthermore, the moderating role of both partners' anxiety and depression was tested. METHODS One hundred cardiac patients (81.5% men) and their partners (81.5% women) completed a self-report questionnaire during hospitalization. The Actor-Partner Interdependence Model (APIM) and moderation analyses were used to assess the above associations. RESULTS Results showed that positive DC was significantly related to higher levels of RS, and negative DC was related to lower levels of RS. Furthermore, patient and partner psychological distress significantly moderated the link between DC and RS: patient-perceived positive DC was associated with higher partner RS when partner depression was high; partner-perceived positive DC was associated with higher patient RS when patient anxiety was low; patient-perceived negative DC has associated with lower patient RS when patient anxiety and depression were high. CONCLUSION This study showed that positive DC is associated with a more satisfying relationship and identified under what conditions of cardiac-related distress this can happen. Furthermore, this study underlined the importance of examining DC in addition to the individual coping skills as a process pertaining to personal well-being and couple's outcomes.
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Affiliation(s)
- Giada Rapelli
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy;
| | - Silvia Donato
- Department of Psychology, Catholic University of Sacred Heart, 20123 Milan, Italy; (S.D.); (A.B.); (G.C.)
- Family Studies and Research University Centre, Catholic University of Sacred Heart, 20123 Milan, Italy
| | - Emanuele Maria Giusti
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of Sacred Heart, 20123 Milan, Italy; (S.D.); (A.B.); (G.C.)
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy
| | - Miriam Parise
- Department of Psychology, Catholic University of Sacred Heart, 20123 Milan, Italy; (S.D.); (A.B.); (G.C.)
- Family Studies and Research University Centre, Catholic University of Sacred Heart, 20123 Milan, Italy
| | | | - Chiara A. M. Spatola
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy;
| | - Anna Bertoni
- Department of Psychology, Catholic University of Sacred Heart, 20123 Milan, Italy; (S.D.); (A.B.); (G.C.)
- Family Studies and Research University Centre, Catholic University of Sacred Heart, 20123 Milan, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Sacred Heart, 20123 Milan, Italy; (S.D.); (A.B.); (G.C.)
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy
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Zhang A, Zheng X, Shen Q, Zhang Q, Leng H. Family management experience of parents of children with chronic heart failure: A qualitative study. J Pediatr Nurs 2023; 73:e36-e42. [PMID: 37481387 DOI: 10.1016/j.pedn.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/09/2023] [Accepted: 07/09/2023] [Indexed: 07/24/2023]
Abstract
PURPOSE To explore the experience of family management among parents of children with chronic heart failure. DESIGN AND METHODS Qualitative descriptive phenomenology was used as the research design. The sample included 16 parents. For data collection, semi-structured interviews were conducted. Colaizzi's seven-step analysis method was used for data analysis. Themes were encoded and created with Nvivo 12.0 Plus software. RESULTS Three themes and ten sub-themes were identified: (1) weakened family socialization (diminished parental role in social education and insufficient socialization of children), (2) experience of five psychological stages (resistance, self-blame, worry, exhaustion, acceptance), and (3) family management dilemmas (low social awareness of the disease, heavy economic burden, and limited coping style). CONCLUSION The experience of parents of children with chronic heart failure is complex. The children have low socialization and face public prejudice. Parents are stressed by social education, economics, and the five psychological stages they have experienced. Families face difficulties such as heavy economic burdens and limited coping styles. PRACTICE IMPLICATIONS To address these complexities, pediatric nursing staff should take steps to improve family management and, as a result, children's quality of life. Our study provides a resource for pediatric nursing staff when implementing family management interventions.
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Affiliation(s)
- Ai Zhang
- Department of Cardiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xianlan Zheng
- Department of Nursing Children's Hospital of Chongqing Medical University, China.
| | - Qiao Shen
- Department of Nursing Children's Hospital of Chongqing Medical University, China
| | - Qin Zhang
- Department of Cardiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Hongyao Leng
- Department of Nursing Children's Hospital of Chongqing Medical University, China
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Riegel B, Barbaranelli C, Quinn R, Matus A, Stawnychy MA, Hirschman KB. Psychometric Analysis of the Health Self-Care Neglect Scale. J Cardiovasc Nurs 2023:00005082-990000000-00132. [PMID: 37755707 DOI: 10.1097/jcn.0000000000001047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
OBJECTIVES The Health Self-Care Neglect (HSCN) scale is a measure of self-care neglect developed for use in informal caregivers, where self-care is defined as behaviors undertaken to maintain health. There was no formal psychometric analysis of the scale, so we tested a 9-item, dichotomous-response version of the HSCN scale in a sample of 250 informal caregivers of adults with chronic heart failure. METHODS As the indicators of self-care neglect were considered formative (influencing the latent variable directly) rather than reflective (influenced by the latent variable), we used a procedure for the specification of formative measurement models. First, maximally correlated composites of indicators were identified for the latent variable, and optimal scoring weights were developed. Then, the reflective factor was tested with confirmatory factor analysis, and longitudinal invariance of the factorial structure was tested by introducing model constraints. Reliability was assessed with composite reliability model-based estimates. Concurrent validity was assessed by correlating the HSCN scale total score with the maintenance scale score of the Self-Care Inventory. RESULTS Strict invariance, the highest level possible, was achieved. Reliability was 0.81 at baseline. Concurrent validity was demonstrated (r = -0.475, P < .0001). CONCLUSION The results of this analysis indicate that the HSCN scale is reliable, stable, and valid as a measure of health self-care neglect when tested in a sample of caregivers. The HSCN scale measures the successful performance of self-care, whereas existing measures of self-care reflect intention. Understanding both intention and behavior is useful, so we recommend using the HSCN scale in addition to existing measures of self-care.
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Gandhi M, Tan RS, Lim SL, Teo I, Yang G, Woo KL, Cheung YB. Measurement Properties of the 15-Item Singapore Caregiver Quality of Life Scale (SCQOLS-15) in Family Caregivers of Patients with Heart Diseases. THE PATIENT 2023; 16:485-495. [PMID: 37341962 DOI: 10.1007/s40271-023-00634-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE To evaluate the measurement properties of the 15-item Singapore Caregiver Quality of Life Scale (SCQOLS-15) in family caregivers of patients with heart diseases. METHODS The SCQOLS-15 survey was self-administered by family caregivers of patients with chronic heart diseases, at baseline and 1 week later. The criterion validity of SCQOLS-15 and its domain scores was assessed by calculating the Spearman correlation coefficient (ρ) with the Brief Assessment Scale for Caregivers (BASC), Caregiver Reaction Assessment (CRA), and their sub-scores. Known-group validity was assessed using the New York Heart Association (NYHA) functional class. Test-retest reliability was evaluated using the intraclass correlation coefficient (ICC). RESULTS Of the 327 caregivers included, 65% were adult children and 28% were spouses. The distribution of NYHA classes of the patients was I: 27%, II: 40%, III: 24%, and IV: 9%. There was a positive correlation between the SCQOLS-15 and BASC total scores (ρ = 0.7). SCQOLS-15 domain scores were also correlated with BASC and CRA sub-scores as per a priori hypotheses, with absolute values of ρ ranging from 0.4 to 0.6. The mean values of SCQOLS-15 total and all domain scores were lower among caregivers of patients with NYHA class III/IV compared to those of class I/II patients (each P < 0.05). Among 146 caregivers who completed the follow-up and self-rated a stable quality-of-life, ICCs for test-retest reliability of SCQOLS-15 total and all domain scores were ≥ 0.8. CONCLUSION The SCQOLS-15 is a valid and reliable instrument for measuring the quality of life in caregivers of heart disease patients.
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Affiliation(s)
- Mihir Gandhi
- Singapore Clinical Research Institute, Consortium for Clinical Research and Innovation Singapore, Singapore, Singapore.
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore.
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.
- Tampere Center for Child, Adolescent, and Maternal Health Research: Global Health Group, Tampere University, Tampere, Finland.
| | - Ru-San Tan
- Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore
| | - Shir Lynn Lim
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
- Department of Medicine, National University of Singapore, Singapore, Singapore
- Pre-hospital and Emergency Research Center, Duke-NUS Medical School, Singapore, Singapore
| | - Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
- Division of Psychosocial Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Grace Yang
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
- Division of Supportive & Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Kai Lee Woo
- Department of Cardiology, National University Heart Centre, Singapore, Singapore
| | - Yin Bun Cheung
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
- Tampere Center for Child, Adolescent, and Maternal Health Research: Global Health Group, Tampere University, Tampere, Finland
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Fumagalli C, Smorti M, Ponti L, Pozza F, Argirò A, Credi G, Di Mario C, Marfella R, Marchionni N, Olivotto I, Perfetto F, Ungar A, Cappelli F. Frailty and caregiver relationship quality in older patients diagnosed with transthyretin cardiac amyloidosis. Aging Clin Exp Res 2023; 35:1363-1367. [PMID: 37129709 DOI: 10.1007/s40520-023-02419-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/18/2023] [Indexed: 05/03/2023]
Abstract
Aim of the study was to explore frailty and quality of the relationship with the caregiver in a cohort of older patients with transthyretin cardiac amyloidosis (ATTR-CA). Sixty-eight consecutive ATTR-CA patients were recruited and assessed for frailty, depressive symptoms, quality of the relationship in terms of social support, or conflict toward caregivers, New York Heart Association Class (NYHA), and National Amyloid Center score (NAC Score) for grading disease severity. Results showed that 10% of patients were frail. Depressive symptoms were present in 46% of patients. Regression analyses showed that both mFI and depression were associated with worse perception of social support, and that mFI and NAC score were associated with higher levels of conflict perceived in the caregivers' relationship. Overall, the mFI score was associated with worse perceived social support and caregiver relationship quality. Tertiary care heart failure clinics should actively support the patient-caregiver relationship to improve quality of life.
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Affiliation(s)
- Carlo Fumagalli
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
| | - Martina Smorti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Lucia Ponti
- Department of Humanities, University of Urbino, 61029, Urbino, Italy.
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy.
| | - Francesca Pozza
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Alessia Argirò
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy
| | - Giacomo Credi
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
| | - Carlo Di Mario
- Division of Interventional Structural Cardiology, Cardiothoracovascular Department, Careggi University Hospital, Florence, Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Niccolò Marchionni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Iacopo Olivotto
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
- Meyer Children Hospital, Florence, Italy
| | - Federico Perfetto
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy
- IV Internal Medicine Division, Careggi University Hospital, Florence, Italy
| | - Andrea Ungar
- Geriatric Intensive Care Unit, University of Florence, Florence, Italy
| | - Francesco Cappelli
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy
- Division of Interventional Structural Cardiology, Cardiothoracovascular Department, Careggi University Hospital, Florence, Italy
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