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The role of dyadic confidence on engagement in heart failure care behaviors
Lyons, Karen S. Gelow, Jill M. Hiatt, Shirin O. Mudd, James O. Auld, Jonathan Chien, Christopher V. Lee, Christopher S.
Lyons, Karen S.
Gelow, Jill M.
Hiatt, Shirin O.
Mudd, James O.
Auld, Jonathan
Chien, Christopher V.
Lee, Christopher S.
Abstract
Background and Objectives
Increasingly, older adults and their families are expected to manage complex conditions with little support. In the case of heart failure (HF), symptom monitoring and management are critical in preventing acute exacerbations and poor clinical outcomes. The current study examined the role of dyadic confidence on engagement in HF care behaviors by patients and their spouses.
Research Design and Methods
A cross-sectional design was used to examine 60 couples living with HF. Three dyadic confidence variables were created to represent average level of confidence, gap in confidence, and direction of gap within each couple. A series of multilevel models were used to examine dyadic engagement in HF maintenance, management, and consulting behaviors and the role of dyadic confidence.
Results
Patients were significantly more engaged in HF maintenance behaviors than spouses; couples were more collaborative in their engagement in HF management and consulting behaviors. Average level of confidence in the dyad was significantly associated with patient engagement in all three HF behaviors. Spouse engagement was associated with more congruence in confidence and having higher levels of confidence than their partners with HF. Women were significantly more engaged in HF behaviors than men, regardless of role.
Discussion and Implications
The study employed a dyadic approach to HF care and a novel approach to confidence. Findings confirm the social nature of confidence and its important role in HF. Clinicians have opportunities to optimize patient outcomes by fostering greater collaboration within couples.
Keywords
congruence, self-care behaviors, maintenance, management, consulting behaviors
Date
2018
Type
Journal article
Journal
The Gerontologist
Book
Volume
58
Issue
4
Page Range
635-643
Article Number
ACU Department
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled