Article

Caregiving for Patients With Heart Failure: Impact on Patients’ Families

School of Nursing, University of California, Los Angeles, 90095-6917, USA.
American Journal of Critical Care (Impact Factor: 1.6). 11/2011; 20(6):431-41; quiz 442. DOI: 10.4037/ajcc2011472
Source: PubMed

ABSTRACT Factors that affect the impact of caregiving on patients' family members who provide care to patients with heart failure have not been adequately addressed. In addition, social support and positive aspects of caregiving have received little attention.
To identify factors associated with the impact of caregiving.
Self-report data were collected from 76 dyads of patients with heart failure and their family caregivers. Clinical data were obtained from medical records.
A sense of less family support for caregiving was associated with a higher New York Heart Association class of heart failure, being a nonspousal caregiver, lower caregivers' perceived control, and less social support. More disruption of caregivers' schedules was associated with higher class of heart failure, more care tasks, and less social support. Greater impact of caregiving on caregivers' health was related to more recent patient hospitalization, lower caregivers' perceived control, and less social support. Nonwhite caregivers and caregivers whose family member had fewer emergency department visits felt more positive about caregiving than did other caregivers. Social support had a moderating effect on the relationship between patients' comorbid conditions and positive aspects of caregiving.
Caregiving has both positive and negative effects on family caregivers of patients with heart failure. The findings suggest the need for interventions to increase caregivers' sense of control and social support. Family caregivers may need additional support immediately after patient hospitalizations to minimize the negative impact of caregiving.

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Available from: Jill Howie-Esquivel, May 12, 2014
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    • "The results should be interpreted with some caution. Current literature (Clay et al., 2013; Hwang et al., 2011; Morris et al., 1989; Pinquart and Sorensen, 2007) implies that social support could be an essential factor in the relation between providing care and the caregiver's health. Unfortunately, data on social support was not sufficiently available in this study, so household size was used as a limited indicator for social support as it may partially represent the caregiver's social network (Morris et al., 1989; Wellman, 1981 "
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    • "Exactly how this works in practice, however, is not well understood. What is known is that heart failure patients and caregivers who take a collaborative approach to heart failure management have better outcomes like better caregiver quality of life [QOL] (Pressler et al., 2013) and less caregiver strain (Hwang et al., 2011; Luttik et al., 2007a,b), whereas a gap between the patient's and caregiver's appraisal of symptoms and respective contributions to care leads to inadequate symptom management (Janssen et al., 2012; Quinn et al., 2010; Retrum et al., 2013; Rohrbaugh et al., 2008; Sebern and Riegel, 2009). Thus, how patient-caregiver dyads function together in their contributions to care is an important consideration in the overall management of heart failure. "
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