Burden among informal caregivers of individuals with heart failure: A mixed methods study

Examining Heart Failure Informal Care Partners Using Person and System Levels and Domains: A Meta-Synthesis

BACKGROUND

Within the last decade, system and policy-level changes have driven substantial shifts in heart failure (HF) care from hospital to home, requiring greater support from informal care partners. What has not been examined is the state of the care partner science by person and system-level domains using qualitative studies to understand impact across multiple person and system levels.

OBJECTIVES

(1) Identify by person and system levels and domain what is known about informal care partners and (2) Identify gaps in the caregiving science and suggest ways to move forward.

METHODS

This secondary analysis of a large HF systematic review is guided by the National Institute on Minority Health and Health Disparities and MIRACLE frameworks and uses meta-synthesis techniques with critical realist approaches to synthesize and interpret the themes across papers.

RESULTS

Using data from 46 papers and 1695 care partners, we identified patterns occurring across 6 domains (biological, behavioral, affective, physical/built environment, sociocultural environment, and healthcare system) and on 4 levels (individual, interpersonal, community, and societal). Existing research predominantly addressed affective and behavioral domains, followed by health system and sociocultural domains. Few studies focused on biological and physical/built environment domains, leaving large gaps in what is known about caregiving at the cellular (biological) and societal (community and societal) levels.

CONCLUSIONS

HF caregiving continues to be studied at a very rudimentary level. This synthesis also reveals critical gaps in what is known about caregiving within the physical/built environment domain and at the community and societal levels.

Latent profile analysis of anticipatory grief in family caregivers of patients with chronic heart failure and its influencing factors

BACKGROUND

Anticipatory grief has been shown to be highly prevalent among family caregivers of patients with advanced illness. However, there is less research on the anticipatory grief of family caregivers with chronic heart failure. Therefore, the purpose of this study was to explore the profile of anticipatory grief among family caregivers of patients with chronic heart failure and to analyze the influencing factors of different profiles.

METHODS

A convenience sampling method was adopted to select 205 family caregivers of chronic heart failure patients hospitalized in a tertiary general hospital in Nanchong, China as the research subjects. A general information questionnaire, Anticipatory Grief Scale (AGS), and Fear of Progression Questionnaire-Short Form (FoP-Q-SF) were used for the survey. Latent profile analysis was conducted on the anticipatory grief of family caregivers of chronic heart failure patients, and univariate analysis and multinomial logistic regression analysis were used to explore the influencing factors of anticipatory grief in each subgroup.

RESULTS

The anticipatory grief of family caregivers of chronic heart failure patients has been divided into three latent classes: low anticipatory grief class (16.4%), moderate anticipatory grief class (58.7%), and high anticipatory grief and loss class (24.8%). Gender, education, relationship with the patient, course of disease, and fear of progression were the influencing factors of the latent profile of anticipatory grief among family caregivers of chronic heart failure patients (all P < 0.05).

CONCLUSION

There were differences in the level of anticipatory grief among different subgroups of family caregivers of chronic heart failure patients. Medical staff can develop personalized intervention measures on the basis of the influencing factors of different categories to alleviate anticipatory grief of family caregivers and promote physical and mental health of caregivers in chronic heart failure patients.