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Cited by 109Heart Failure Treatment and ManagementNursing care and researchCardiac Health and Mental Health

Patterns and predictors of patient and caregiver engagement in heart failure care: a multi-level dyadic study

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Lee, Christopher S., Vellone, Ercole, Lyons, Karen S., Cocchieri, Antonello, Bidwell, Julie T., D’Agostino, Fabio, Hiatt, Shirin O., Alvaro, Rosaria +2 more·2015·International Journal of Nursing Studies
DOI 10.1016/j.ijnurstu.2014.11.005
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Abstract

Background Heart failure is a burdensome clinical syndrome, and patients and their caregivers are responsible for the vast majority of heart failure care.Objectives This study aimed to characterize naturally occurring archetypes of patient-caregiver dyads with respect to patient and caregiver contributions to heart failure self-care, and to identify patient-, caregiver- and dyadic-level determinants thereof.Design Dyadic analysis of cross-sectional data on patients and their caregivers.Setting Outpatient heart failure clinics in 28 Italian provinces.Participants 509 Italian heart failure patients and their primary caregivers.Methods Multilevel and mixture modeling were used to generate dyadic averages and incongruence in patient and caregiver contributions to heart failure self-care and identify common dyadic archetypes, respectively.Results Three distinct archetypes were observed. 22.4% of dyads were labeled as novice and complementary because patients and caregivers contributed to different aspects of heart failure self-care that was generally poor; these dyads were predominantly older adults with less severe heart failure and their adult child caregivers. 56.4% of dyads were labeled as inconsistent and compensatory because caregivers reported greater contributions to the areas of self-care most insufficient on the part of the patients; patients in these dyads had the highest prevalence of hospitalizations for heart failure in the past year and the fewest limitations to performing activities of daily living independently. Finally, 21.2% of dyads were labeled as expert and collaborative because of high contributions to all aspects of heart failure self-care, the best relationship quality and lowest caregiver strain compared with the other archetypes; patients in this archetype were likely the sickest because they also had the worst heart failure-related quality of life.Conclusion Three distinct archetypes of dyadic contributions to heart failure care were observed that represent a gradient in the level of contributions to self-care, in addition to different approaches to working together to manage heart failure. Interventions and clinical programs that involve heart failure dyads should tailor strategies to take into consideration these distinct archetypes and their attributes.

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  • Emotional and behavioral responses of chronic heart failure patients and their family caregivers result in a strained dyadic relationship between patients and their family caregivers.

    “These emotional and behavioral responses affect the other person [37], resulting in a strained dyadic relationship between patients and their FCs [38], poorer physical functioning of patients [39], and reduced QOL of both patients and their FCs [35, 40].”

    From Effectiveness of a videoconferencing group-based dyad acceptance and commitment therapy on the quality of life of chronic heart failure patients and their family caregivers: A study protocol for a randomized controlled trial (2024) · cites this paper as [38]

    The Discussion reports that communication problems are a source of stress for heart-failure families, and it describes differences in relationship quality among patient–caregiver dyads. It does not establish that patients’ and caregivers’ emotional and behavioral responses cause a strained relationship; the study’s dyadic analysis is cross-sectional. (LLM, conf=0.79)

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Authors
Lee, C. S., Vellone, E., Lyons, K. S., Cocchieri, A., Bidwell, J. T., D’Agostino, F., Hiatt, S. O., Alvaro, R., Buck, H. G., & Riegel, B.
Affiliations
  • Oregon Health & Science University (US)
  • University of Rome Tor Vergata (IT)
  • Pennsylvania State University (US)
  • University of Pennsylvania (US)
Corresponding author
Lee, Christopher S.
ORCID
Venue
International Journal of Nursing Studies
Publisher
Elsevier BV
Published
2015-02
Volume
52
Issue
2
Pages
588-597
ISSN
0020-7489 (ISSN-L)
DOI
10.1016/j.ijnurstu.2014.11.005
OpenAlex
W1966992428
Cited by
109
References
44
Citations by year
2026: 4 · 2025: 5 · 2024: 1 · 2023: 4 · 2022: 11 · 2021: 14 · 2020: 18 · 2019: 8 · 2018: 11 · 2017: 19 · 2016: 11 · 2015: 3
FWCI
7.54
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Nursing Studies (publishedVersion)
  • PubMed (publishedVersion)
  • Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion, other-oa)
  • Digital Commons - University of South Florida (University of South Florida) (submittedVersion)
  • Research Bank (Australian Catholic University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords
heart failure, patient-caregiver dyads, self-care, caregiver burden, caregiver contribution, patient contribution, relationship quality, heart failure hospitalization, activities of daily living, adult child caregivers, outpatient heart failure clinic
MeSH terms
Activities of Daily Living, Adult, Aged, Family, Female, Heart Failure, Hospitalization, Humans, Interpersonal Relations, Male, Models, Theoretical, Patients, Quality of Life, Self Care, Caregivers

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