Association Between Benefit Finding and Self-care Management in Heart Failure Patient-Caregiver Dyads

Abstract

Background Inadequate self-care management has been reported in patients with heart failure (HF) and their family caregivers. However, evidence on the influencing factors and corresponding action paths for self-care management within a dyadic context is limited. Objective The aim of this study was to examine dyadic associations between benefit finding and self-care management in HF patient-caregiver dyads and the mediating role of mutuality in these associations. Methods This cross-sectional study was conducted in China, and a convenience sample of 253 HF patient-caregiver dyads was included in the analysis. Dyadic benefit finding and mutuality, patients' self-care management, and caregivers' contributions to self-care management were measured using self-reported questionnaires. The actor-partner interdependence model and actor-partner interdependence mediation model were adopted to analyze the data. Results Patients' benefit finding had an actor effect on their own self-care management (β = 0.134, P < .05) and a partner effect on caregivers' contributions to self-care management (β = 0.130, P < .05). Similarly, caregivers' benefit finding had an actor effect on their contributions to self-care management (β = 0.316, P < .01) and a partner effect on patients' self-care management (β = 0.187, P < .01). Moreover, patients' mutuality completely mediated the actor effect of their benefit finding on self-care management (β = 0.127; 95% confidence interval, 0.032–0.233), and caregivers' mutuality partially mediated the actor effect of their benefit finding on contributions to self-care management (β = 0.060; 95% confidence interval, 0.012–0.124). In addition, caregivers' mutuality completely mediated the partner effect of patients' benefit finding on caregivers' contributions to self-care management (β = 0.036; 95% confidence interval, 0.009–0.081). Conclusions The findings revealed the importance of benefit finding and mutuality, 2 modifiable factors positively associated with dyadic HF self-care management. Dyadic interventions targeting on enhancing benefit finding and mutuality should be designed and implemented to improve HF self-care management.

Advances in the Science of Heart Failure Self-care

“…The article from Graven et al 12 conceptualized self-care as a dyadic phenomenon, a view widely endorsed by others. [13][14][15] So, studies that capture the contribution of caregivers to patients' self-care are important. Locatelli and colleagues 16 explored patient self-care as a mediator of the relationship between caregiver contributions to self-care and symptom burden.…”

“…The article from Graven et al 12 conceptualized self-care as a dyadic phenomenon, a view widely endorsed by others 13–15 . So, studies that capture the contribution of caregivers to patients' self-care are important.…”