The Influence of Caregiver Contribution to Self-care on Symptom Burden in Patients With Heart Failure and the Mediating Role of Patient Self-care

被引：10

作者：

Locatelli, Giulia ^{[1
,2
,10
]}

Iovino, Paolo ^{[3
]}

Jurgens, Corrine Y. ^{[4
]}

Alvaro, Rosaria ^{[1
]}

Uchmanowicz, Izabella ^{[5
]}

Rasero, Laura ^{[3
]}

Riegel, Barbara ^{[6
,7
,8
,9
]}

Vellone, Ercole ^{[1
,5
]}

机构：

[1] Univ Roma Tor Vergata, Dept Biomed & Prevent, Rome, Italy

[2] Australian Catholic Univ, Fac Hlth Sci, Sch Nursing Midwifery & Paramedicine, Melbourne, Australia

[3] Univ Florence, Hlth Sci Dept, Florence, Italy

[4] Boston Coll, William F Connell Sch Nursing, Chestnut Hill, MA USA

[5] Wroclaw Med Univ, Fac Hlth Sci, Dept Nursing & Obstet, Wroclaw, Poland

[6] Univ Penn, Sch Nursing, Philadelphia, PA USA

[7] VNS Hlth, Ctr Home Care Policy & Res, New York, NY USA

[8] Australian Catholic Univ, Mary MacKillop Inst Hlth Res, Melbourne, Australia

[9] Int Ctr Selfcare Res, Melbourne, Australia

[10] Univ Roma Tor Vergata, Via Montpellier 1, I-00133 Rome, Italy

来源：

JOURNAL OF CARDIOVASCULAR NURSING | 2024年 / 39卷 / 03期

关键词：

caregivers; heart failure; mediation analysis; self-care; symptom assessment; QUALITY-OF-LIFE; COGNITIVE IMPAIRMENT; SOMATIC PERCEPTION; ESC GUIDELINES; FIT INDEXES; MOTIVATE-HF; SLEEP; EPIDEMIOLOGY; PREDICTORS; DIAGNOSIS;

D O I：

10.1097/JCN.0000000000001024

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundPatients with heart failure experience high symptom burden, which can be mitigated with adequate self-care. Caregiver contribution to self-care has been theorized to improve patient symptom burden. The mediating role of patient self-care in this relationship has not been tested yet. ObjectivesThe aim of this study was to test whether (a) caregiver contribution to self-care influences patient self-care, (b) patient self-care influences symptom burden, and (c) patient self-care mediates the relationship between caregiver contribution to self-care and symptom burden. MethodsIn this study, the authors conducted a secondary analysis of the baseline and 3-month data from the MOTIVATE-HF trial, which enrolled 510 dyads (patient with heart failure and caregiver) in Italy. Multigroup confirmatory factor analysis was used to test measurement invariance. Autoregressive longitudinal path analysis with contemporaneous mediation was used to test our hypotheses. ResultsOn average, caregivers were 54 years old and mainly female, whereas patients were 72.4 years old and mainly male. Better caregiver contribution to self-care maintenance was associated with better patient self-care maintenance (beta = 0.280, P < .001), which, in turn, was associated with lower symptom burden (beta = -0.280, P < .001). Patient self-care maintenance mediated the effect of caregiver contribution to self-care maintenance on symptom burden (beta = -0.079; 95% bias-corrected bootstrapped confidence interval, -0.130 to -0.043). Better caregiver contribution to self-care management was associated with better patient self-care management (beta = 0.238, P = .006). The model significantly accounted for 37% of the total variance in symptom burden scores (P < .001). ConclusionsThis study expands the situation-specific theory of caregiver contribution to heart failure self-care and provides new evidence on the role of caregiver contribution to self-care and patient self-care on symptom burden in heart failure.

引用

页码：255 / 265

页数：11

共 62 条

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