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Patterns, relevance and predictors of heart failure dyadic symptom appraisal
Lee, Christopher S. Mudd, James O. Auld, Jonathan Gelow, Jill M. Hiatt, Shirin O. Chien, Christopher V. Bidwell, Julie T. Lyons, Karen S.
Lee, Christopher S.
Mudd, James O.
Auld, Jonathan
Gelow, Jill M.
Hiatt, Shirin O.
Chien, Christopher V.
Bidwell, Julie T.
Lyons, Karen S.
Abstract
Background
Caregivers are thought to play a major role in helping patients first appraise and then respond to heart failure (HF) symptoms.
Aims
The aims of this study were to: (a) characterise distinct patterns of HF patient–caregiver dyads with respect to symptom appraisal; and (b) link dyadic symptom appraisal to contributions to self-care and caregiver strain.
Methods and results
A cross-sectional dyadic descriptive design was used to capture patient and caregiver appraisal of patient HF symptoms (i.e. dyspnoea, fatigue, pain and anxiety). Contributions to self-care were measured using patient and caregiver versions of the Self-Care of Heart Failure Index and the European Heart Failure Self-care Behaviour Scale. Caregiver strain was measured using the Multidimensional Caregiver Strain Index. Multilevel and latent class mixture modelling (LCMM) were used to examine distinct patterns of symptom appraisal. Two patterns of dyadic symptom appraisal were identified: one pattern (n = 24; 38.7%) wherein caregivers appraised patients’ symptoms as being significantly worse than did the patient (labelled as ‘Caregiver > Patient’); and a second pattern (n = 38; 61.3%) wherein patients appraised their symptoms similar to or worse than that as perceived by their caregiver (labelled as ‘Patient ⩾ Caregiver’). Dyads in the Caregiver > Patient pattern of symptom appraisal reported much better contributions to self-care (symptom response behaviours only), but also greater caregiver strain, compared with dyads in the Patient ⩾ Caregiver pattern. Greater patient depression and older caregiver age were significant determinants of fitting the Patient ⩾ Caregiver pattern.
Conclusion
Differences in how HF patients and caregivers appraise symptoms together must be taken into consideration when examining contributions to HF care and caregiver outcomes.
Keywords
caregiving, self-care, heart failure
Date
2017
Type
Journal article
Journal
European Journal of Cardiovascular Nursing
Book
Volume
16
Issue
7
Page Range
595-604
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