Karen S Lyons1, Ercole Vellone, Christopher S Lee, Antonello Cocchieri, Julie T Bidwell, Fabio D'Agostino, Shirin O Hiatt, Rosaria Alvaro, Raul Juarez Vela, Barbara Riegel. 1. Karen S. Lyons, PhD Associate Professor, School of Nursing, Oregon Health & Science University, Portland, OR, USA. Ercole Vellone, PhD, RN Research fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Christopher S. Lee, PhD, RN, FAHA, FAAN Associate Professor, School of Nursing, Oregon Health & Science University, Portland. Antonello Cocchieri, PhD, RN Consultant, Nursing Service, Catholic University, Rome, Italy. Julie T. Bidwell, BSN, RN PhD Student, School of Nursing, Oregon Health & Science University, Portland. Fabio D'Agostino, PhD, RN Research fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Shirin O. Hiatt, MPH, MS, RN Research Associate, School of Nursing, Oregon Health & Science University, Portland. Rosaria Alvaro, MSN, RN Associate Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Raul Juarez Vela, PhD, RN Research Fellow, Faculty of Health Sciences, University San Jorge, Zaragoza, Spain. Barbara Riegel, PhD, RN, FAHA, FAAN Professor, School of Nursing, University of Pennsylvania, Philadelphia.
Abstract
BACKGROUND: The majority of heart failure (HF) self-care research remains focused on patients, despite the important involvement of family caregivers. Although self-care confidence has been found to play an important role in the effectiveness of HF self-care management on patient outcomes, no known research has examined self-care confidence within a dyadic context. OBJECTIVE: The purpose of this study was to identify individual and dyadic determinants of self-care confidence in HF care dyads. METHODS: Multilevel modeling, which controls for the interdependent nature of dyadic data, was used to examine 329 Italian HF dyads (caregivers were either spouses or adult children). RESULTS: Both patients and caregivers reported lower-than-adequate levels of confidence, with caregivers reporting slightly higher confidence than patients. Patient and caregiver levels of confidence were significantly associated with greater patient-reported relationship quality and better caregiver mental health. Patient confidence in self-care was significantly associated with patient female gender, nonspousal care dyads, poor caregiver physical health, and low care strain. Caregiver confidence to contribute to self-care was significantly associated with poor emotional quality of life in patients and greater perceived social support by caregivers. CONCLUSIONS: Findings are supportive of the need for a dyadic perspective of HF self-care in practice and research as well as the importance of addressing the needs of both members of the dyad to maximize optimal outcomes for both.
BACKGROUND: The majority of heart failure (HF) self-care research remains focused on patients, despite the important involvement of family caregivers. Although self-care confidence has been found to play an important role in the effectiveness of HF self-care management on patient outcomes, no known research has examined self-care confidence within a dyadic context. OBJECTIVE: The purpose of this study was to identify individual and dyadic determinants of self-care confidence in HF care dyads. METHODS: Multilevel modeling, which controls for the interdependent nature of dyadic data, was used to examine 329 Italian HF dyads (caregivers were either spouses or adult children). RESULTS: Both patients and caregivers reported lower-than-adequate levels of confidence, with caregivers reporting slightly higher confidence than patients. Patient and caregiver levels of confidence were significantly associated with greater patient-reported relationship quality and better caregiver mental health. Patient confidence in self-care was significantly associated with patient female gender, nonspousal care dyads, poor caregiver physical health, and low care strain. Caregiver confidence to contribute to self-care was significantly associated with poor emotional quality of life in patients and greater perceived social support by caregivers. CONCLUSIONS: Findings are supportive of the need for a dyadic perspective of HF self-care in practice and research as well as the importance of addressing the needs of both members of the dyad to maximize optimal outcomes for both.
Authors: Barbara Riegel; Victoria Vaughan Dickson; Christopher S Lee; Marguerite Daus; Julia Hill; Elliane Irani; Solim Lee; Joyce W Wald; Stephen T Moelter; Lisa Rathman; Megan Streur; Foster Osei Baah; Linda Ruppert; Daniel R Schwartz; Alfred Bove Journal: Heart Lung Date: 2018-01-03 Impact factor: 2.210
Authors: Elliane Irani; Scott Emory Moore; Ronald L Hickman; Mary A Dolansky; Richard A Josephson; Joel W Hughes Journal: J Cardiovasc Nurs Date: 2019 Jul/Aug Impact factor: 2.083
Authors: Julie T Bidwell; Melinda K Higgins; Carolyn M Reilly; Patricia C Clark; Sandra B Dunbar Journal: Heart Lung Date: 2017-11-15 Impact factor: 2.210