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Cited by 97Nursing care and researchHeart Failure Treatment and ManagementPalliative Care and End-of-Life Issues

Patient and Caregiver Congruence: The Importance of Dyads in Heart Failure Care

Retrum, Jessica H., Nowels, Carolyn T., Bekelman, David B.·2013·Journal of Cardiovascular Nursing
DOI 10.1097/jcn.0b013e3182435f27
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Abstract

BACKGROUND: Informal (family) caregivers are integrally involved in chronic heart failure (HF) care. Few studies have examined HF patients and their informal caregiver as a unit in a relationship, or a dyad. Dyad congruence, or consistency in perspective, is relevant to numerous aspects of living with HF and HF care. Incongruence or lack of communication could impair disease management and advance care planning. OBJECTIVES: The purpose of this qualitative study was to examine for congruence and incongruence between HF patients and their informal (family) caregivers. Secondary analyses examined the relationship of congruence to emotional distress and whether dyad relationship characteristics (eg, parent-child vs spouse) were associated with congruence. METHODS: Thirty-four interviews consisting of HF patients and their current informal caregiver (N = 17 dyads) were conducted. Each dyad member was asked similar questions about managing HF symptoms, psychosocial care, and planning for the future. Interviews were transcribed and analyzed using the general inductive approach. RESULTS: Congruence, incongruence, and lack of communication between patients and caregivers were identified in areas such as managing illness, perceived care needs, perspectives about the future of HF, and end-of-life issues. Seven dyads were generally congruent, 4 were incongruent, and 6 demonstrated a combination of congruence and incongruence. Much of the tension and distress among dyads related to conflicting views about how emotions should be dealt with or expressed. Dyad relationship (parent-child vs spouse) was not clearly associated with congruence, although the relationship did appear to be related to perceived caregiving roles. CONCLUSIONS: Several areas of HF clinical and research relevance, including self-care, advance care planning, and communication, were affected by congruence. Further research is needed to define how congruence is related to other relationship characteristics, such as relationship quality, how congruence can best be measured quantitatively, and to what degree modifying congruence will lead to improved HF patient and caregiver outcomes.

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Authors
Retrum, J. H., Nowels, C. T., & Bekelman, D. B.
Affiliations
  • University of Colorado Denver (US)
  • University of Denver (US)
Corresponding author
Retrum, Jessica H.
ORCID
Venue
Journal of Cardiovascular Nursing
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2013-03
Volume
28
Issue
2
Pages
129-136
ISSN
0889-4655 (ISSN-L)
DOI
10.1097/jcn.0b013e3182435f27
OpenAlex
W2313207675
Cited by
97
References
25
Citations by year
2026: 4 · 2025: 4 · 2024: 5 · 2023: 5 · 2022: 6 · 2021: 3 · 2020: 12 · 2019: 4 · 2018: 8 · 2017: 11 · 2016: 9 · 2015: 6 · 2014: 9 · 2013: 9 · 2012: 2
FWCI
20.75
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Cardiovascular Nursing (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Colorado College
  • University of Colorado Denver
  • University of Colorado School of Medicine, Anschutz Medical Campus
Topics
  • Health Sciences › Health Professions › Pharmacy › Nursing care and research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
Keywords
chronic heart failure, informal caregivers, family caregivers, patient-caregiver dyads, caregiver-patient communication, emotional distress, advance care planning, end-of-life care, self-care, caregiver role, parent-child relationship, marital relationships
MeSH terms
Adult, Aged, Aged, 80 and over, Attitude to Health, Chronic Disease, Colorado, Communication, Emotions, Female, Heart Failure, Humans, Interpersonal Relations, Male, Middle Aged, Parent-Child Relations, Self Care, Caregivers, Spouses, Advance Care Planning, Qualitative Research

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