Caregivers' Perceived Roles in Caring for Patients With Heart Failure: What Do Clinicians Need to Know?

被引:31
作者
Burke, Robert E. [1 ,2 ]
Jones, Jacqueline [3 ]
Ho, P. Michael [4 ,5 ]
Bekelman, David B. [2 ,6 ,7 ]
机构
[1] Denver VA Med Ctr, Hosp Med Sect, Denver, CO 80220 USA
[2] Univ Colorado, Sch Med, Dept Med, Div Gen Internal Med, Denver, CO USA
[3] Univ Colorado, Coll Nursing, Denver, CO 80202 USA
[4] Denver VA Med Ctr, Cardiol Sect, Denver, CO 80220 USA
[5] Univ Colorado, Sch Med, Dept Med, Denver, CO USA
[6] Denver VA Med Ctr, Res Sect, Denver, CO 80220 USA
[7] Denver VA Med Ctr, Geriatr Sect, Denver, CO 80220 USA
关键词
Caregiver; self-management; heart failure; qualitative; RANDOMIZED CONTROLLED-TRIAL; QUALITY-OF-LIFE; FAMILY CAREGIVERS; INFORMAL CAREGIVERS; ALZHEIMERS-DISEASE; OLDER-ADULTS; CARE; PROGRAM; HOME; OUTCOMES;
D O I
10.1016/j.cardfail.2014.07.011
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Poor self-management of heart failure (HF) is an essential contributor to poor outcomes. Caregivers are involved in the care of HF patients, but caregiver interventions intended to improve the outcomes of patients have been largely unsuccessful. Improved knowledge of caregivers' desired roles in care may improve future interventions. Methods and Results: This qualitative study of 20 caregivers of BF patients recruited from an academic medical center used a general inductive approach, with insights from role theory, to analyze the data. Caregivers perceived themselves as health care managers and care plan enforcers, advocates for quality of life, and experts in the lived experience of HF at home. However, they encountered role strain (expectations of role exceed ability to perform role) and role conflict (incompatible or contradictory roles) when it seemed that these roles were incompatible with those that they felt the health care system saw them in. This resulted in expressions of anger and distrust towards the health care system. Conclusions: Clinicians caring for patients with BF can seek to better empower and enable this care. Involving caregivers in disease management research and assessing their roles before intervention may hold promise for enabling and empowering caregivers to improve outcomes of HF patients.
引用
收藏
页码:731 / 738
页数:8
相关论文
共 42 条
[11]   A professional-patient partnership model of discharge planning with elders hospitalized with heart failure [J].
Bull, MJ ;
Hansen, HE ;
Gross, CR .
APPLIED NURSING RESEARCH, 2000, 13 (01) :19-28
[12]   Patient experiences of transitioning from hospital to home: An ethnographic quality improvement project [J].
Cain, Carol H. ;
Neuwirth, Estee ;
Bellows, Jim ;
Zuber, Christi ;
Green, Jennifer .
JOURNAL OF HOSPITAL MEDICINE, 2012, 7 (05) :382-387
[13]   The effectiveness of telehealth care on caregiver burden, mastery of stress, and family function among family caregivers of heart failure patients: A quasi-experimental study [J].
Chiang, Li-Chi ;
Chen, Wan-Chou ;
Dai, Yu-Tzu ;
Ho, Yi-Lwun .
INTERNATIONAL JOURNAL OF NURSING STUDIES, 2012, 49 (10) :1230-1242
[14]   Patient and informal caregivers' knowledge of heart failure: necessary but insufficient for effective self-care [J].
Clark, Alexander M. ;
Freydberg, C. Nicole ;
McAlister, Finlay A. ;
Tsuyuki, Ross T. ;
Armstrong, Paul W. ;
Strain, Laurel A. .
EUROPEAN JOURNAL OF HEART FAILURE, 2009, 11 (06) :617-621
[15]   Effects of the home Environmental Skill-Building Program on the caregiver-care recipient dyad: 6-month outcomes from the Philadelphia REACH initiative [J].
Gitlin, LN ;
Winter, L ;
Corcoran, M ;
Dennis, MP ;
Schinfeld, S ;
Hauck, WW .
GERONTOLOGIST, 2003, 43 (04) :532-546
[16]  
Go AS, 2014, CIRCULATION, V129, pE28, DOI 10.1161/01.cir.0000441139.02102.80
[17]   The significance of informal caregivers in information management from the perspective of heart failure patients [J].
Helleso, Ragnhild ;
Eines, Johannes ;
Fagermoen, May Solveig .
JOURNAL OF CLINICAL NURSING, 2012, 21 (3-4) :495-503
[18]   Descriptive study of partners' experiences of living with severe heart failure [J].
Imes, Christopher C. ;
Dougherty, Cynthia M. ;
Pyper, Gail ;
Sullivan, Mark D. .
HEART & LUNG, 2011, 40 (03) :208-216
[19]   Rehospitalizations among Patients in the Medicare Fee-for-Service Program [J].
Jencks, Stephen F. ;
Williams, Mark V. ;
Coleman, Eric A. .
NEW ENGLAND JOURNAL OF MEDICINE, 2009, 360 (14) :1418-1428
[20]   The Work of Spousal Caregiving of Older Adults with End-Stage Heart Failure [J].
Kitko, Lisa A. ;
Hupcey, Judith E. .
JOURNAL OF GERONTOLOGICAL NURSING, 2013, 39 (07) :40-47