The Influence of Caregiver Contribution to Self-care on Symptom Burden in Patients With Heart Failure and the Mediating Role of Patient Self-care A Longitudinal Mediation Analysis
Journal article
Locatelli, Giulia, Iovino, Paolo, Jurgens, Corrine Y., Alvaro, Rosaria, Uchmanowicz, Izabella, Rasero, Laura, Riegel, Barbara Jean and Vellone, Ercole. (2024). The Influence of Caregiver Contribution to Self-care on Symptom Burden in Patients With Heart Failure and the Mediating Role of Patient Self-care A Longitudinal Mediation Analysis. Journal of Cardiovascular Nursing. 39(3), pp. 255-265. https://doi.org/10.1097/JCN.0000000000001024
Authors | Locatelli, Giulia, Iovino, Paolo, Jurgens, Corrine Y., Alvaro, Rosaria, Uchmanowicz, Izabella, Rasero, Laura, Riegel, Barbara Jean and Vellone, Ercole |
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Abstract | Background: Patients 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. Objectives: The 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. Methods: In 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. Results: On 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 (β = 0.280, P < .001), which, in turn, was associated with lower symptom burden (β = −0.280, P < .001). Patient self-care maintenance mediated the effect of caregiver contribution to self-care maintenance on symptom burden (β = −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 (β = 0.238, P = .006). The model significantly accounted for 37% of the total variance in symptom burden scores (P < .001). Conclusions: This 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. |
Keywords | caregivers; heart failure; mediation analysis; self-care; symptom assessment |
Year | 01 Jan 2024 |
Journal | Journal of Cardiovascular Nursing |
Journal citation | 39 (3), pp. 255-265 |
Publisher | Wolters Kluwer Health |
ISSN | 0889-4655 |
Digital Object Identifier (DOI) | https://doi.org/10.1097/JCN.0000000000001024 |
Web address (URL) | https://journals.lww.com/jcnjournal/fulltext/2024/05000/the_influence_of_caregiver_contribution_to.9.aspx |
Open access | Published as ‘gold’ (paid) open access |
Research or scholarly | Research |
Page range | 255-265 |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Jun 2024 | |
Publication process dates | |
Accepted | May 2024 |
Deposited | 27 Aug 2024 |
Additional information | Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. |
This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/ | |
Place of publication | United States |
https://acuresearchbank.acu.edu.au/item/90x2q/the-influence-of-caregiver-contribution-to-self-care-on-symptom-burden-in-patients-with-heart-failure-and-the-mediating-role-of-patient-self-care-a-longitudinal-mediation-analysis
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OA_Riegel_2024_The_influence_of_caregiver_contribution_to.pdf | |
License: CC BY 4.0 | |
File access level: Open |
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