Mutuality and heart failure self-care in patients and their informal caregivers. (February 2018)

• Record Type: Journal Article
• Authors: Hooker, Stephanie A; Schmiege, Sarah J; Trivedi, Ranak B; Amoyal, Nicole R; Bekelman, David B
• Is Part Of: European journal of cardiovascular nursing. Volume 17:Number 2(2018)
• Page Start: 102
• Page End: 113
• Publication Date: 2018-02
• Subjects: Burden -- confidence -- maintenance -- mutuality -- caregiving; Cardiovascular system -- Diseases -- Nursing -- Periodicals; Cardiovascular Diseases -- nursing -- Periodicals; Cardiology -- Periodicals; Nursing -- Periodicals; Vascular Diseases -- Periodicals; 610.7369105
• DOI: 10.1177/1474515117730184
• Languages: English
• ISSNs: 1474-5151

Abstract

Background: Heart failure is a progressive condition characterized by frequent hospitalizations for exacerbated symptoms. Informal family caregivers may help patients improve self-care, which may in turn reduce hospitalizations. However, little is known about how mutuality, defined as the quality of the patient–caregiver relationship, and caregiver burden affect self-care. Objective: This study examines the associations among mutuality, patient self-care confidence (beliefs in abilities to engage in self-care behaviors) and maintenance (behaviors such as medication adherence, activity, and low salt intake), caregiver confidence in and maintenance of patient care, and caregiver perceived burden. Methods: This study used cross-sectional baseline data from a multi-site randomized clinical trial of a symptom and psychosocial care intervention. Patient–caregiver dyads ( N =99) completed self-report surveys of mutuality and self-care confidence and maintenance, and caregivers completed a measure of caregiver burden. Path analysis, with actor (effects within a person) partner (effects across the dyad) interdependence model paths and regression models were used to examine the associations among mutuality, caregiver burden, and self-care. Results: The majority of patients ( M age=66, 21% female) and caregivers ( M age=57, 81% female) were spouses (60%). The path model demonstrated significant actor effects; patients and caregivers with better mutuality were more confident in patient self-care ( p <.05). Partner effects were not significant. Regression models indicated that caregivers with greater mutuality reported less perceived burden ( p <.01). Conclusions: Mutuality in patient–caregiver dyads is associated with patient self-care and caregiver burden and may be an important intervention target to improve self-care and reduce hospitalizations.