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

Abstract

Background 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. Objective To identify factors associated with the impact of caregiving. Methods Self-report data were collected from 76 dyads of patients with heart failure and their family caregivers. Clinical data were obtained from medical records. Results 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. Conclusions 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.

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

“…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.…”

Palliative Care and Cardiovascular Disease and Stroke: A Policy Statement From the American Heart Association/American Stroke Association

“…120 Caregivers of patients with HF noted that their personal health was compromised after recent patient hospitalizations, demonstrating the impact of patient outcomes on caregiver outcomes. 121 Thus, frequent hospital readmissions or perhaps worsening of a patient's condition leading to hospitalization may result in caregiver distress and a negative impact on caregivers' health.…”

Variability in use of IV nitrates and diuretics in acute HF: a ‘virtual patient’ clinical decision-making study

“…66,190 Caregivers reported receiving a lack of social and emotional support themselves, as well as the need for more information and advice on caring for patients. 189 Furthermore, low levels of perceived social support increased the burden felt by caregivers, suggesting that caregivers would benefit from improved education and support.…”

“…194 Such an approach would, however, require its integration into diseasemanagement programmes and involve effective coordination among healthcare professionals involved in palliative care and in the management of patients with heart failure. Caregivers could benefit from improved education and support 189 Our evidence-based policy recommendations…”

“…191 Family caregivers reported that patient care had a marked impact on their daily schedule, so that activities seemed centred around providing care. 189 Caregiving limited social activities in particular, and negatively affected caregivers' ability to cope with stress and their emotional and financial well-being. 192 However, some caregivers experienced positive feelings from the responsibilities and rewards of caring for a family member.…”