Date of this Version
Journal of Cardiovascular Nursing
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.
This is a non-final version of an article published in final form as Lyons, K.S. et al. A Dyadic Approach to Managing Heart Failure with Confidence. The Journal of Cardiovascular Nursing 30, no. 4S, pp. S64-S71. DOI: 10.1097/JCN.0000000000000234
Lyons, K. S., Vellone, E., Lee, C. S., Cocchieri, A., Bidwell, J. T., D'Agostino, F., Hiatt, S. O., Alvaro, R., Juarez, R., & Riegel, B. (2015). A Dyadic Approach to Managing Heart Failure with Confidence. Journal of Cardiovascular Nursing, 30 (4S), S64-S71. http://dx.doi.org/10.1097/JCN.0000000000000234
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Date Posted: 02 November 2018
This document has been peer reviewed.