Patterns, relevance and predictors of heart failure dyadic symptom appraisal

Lee, Christopher S.; Mudd, James O.; Auld, Jonathan P.; Gelow, Jill M.; Hiatt, Shirin O.; Chien, Christopher; Bidwell, Julie T.; Lyons, Karen S.

doi:10.1177/1474515117700760

Cited by 36 publications

(40 citation statements)

References 45 publications

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“…In caregivers, greater pre‐implantation patient HF symptom burden predicted significant worsening of strain in the first month post‐implantation. Given that caregivers often perceive patients' symptom burden to be greater than the patients themselves report, and greater severity of HF has been associated with greater caregiver strain, it is possible that elevated symptom severity pre‐implantation has a lagged effect on caregivers' ability to cope with caregiving post‐implantation, potentially as a function of sustained hypervigilance . In short, the influence of pre‐implantation HF symptoms on both dyad members underlines the importance of symptoms for patient and caregiver outcomes and suggests that the experience of HF symptoms is a shared one.…”

Section: Discussionmentioning

confidence: 99%

Patient and Caregiver Determinants of Patient Quality of Life and Caregiver Strain in Left Ventricular Assist Device Therapy

Bidwell

Lyons

Mudd

et al. 2018

JAHA

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BackgroundAlthough current guidelines emphasize the importance of social support to the success of left ventricular assist device (LVAD) therapy, few studies examine the influence of the caregiver on patient outcomes or quantify the impact of LVAD caregiving on caregiver outcomes. The purpose of this analysis was to identify patient and caregiver determinants of patient quality of life (QOL) and caregiver strain in response to LVAD therapy.Methods and ResultsData on patients receiving LVAD therapy and their caregivers (n=50 dyads) were prospectively collected pre‐implantation and 1, 3, and 6 months post‐implantation. Growth curve modeling was used to describe change in patient QOL (Kansas City Cardiomyopathy Questionnaire) and caregiver strain (Multidimensional Caregiver Strain Index). Patient QOL improved most in the first month (β=23.22±3.76, P<0.001), followed by gradual gains over 6 months (β=1.90±0.64, P<0.01). Caregivers experienced worsening of strain in the first month (β=4.30±1.42, P<0.01), followed by gradual resolution to pre‐implantation levels by 6 months (β=−0.71±0.23, P<0.01). Worse pre‐implantation patient symptoms were associated with greater improvement in patient QOL (β=0.53±0.19, P<0.01) but worsening caregiver strain (β=0.15±0.07, P=0.04). Better relationship quality was associated with greater improvement in patient QOL (β=14.39±5.85, P=0.01) and less pre‐implantation caregiver strain (β=−9.31±2.28, P<0.001). Nonspousal caregivers experienced less pre‐implantation strain (β=−8.60±3.10, P=0.01), and patients with nonspousal caregivers had less improvement in QOL (β=−3.70±1.62, P=0.02).ConclusionsA combination of patient and caregiver characteristics predicts patient and caregiver response to LVAD therapy. Including caregiver factors in future studies may be helpful in developing interventions that improve patient and caregiver outcomes, together.

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Section: Discussionmentioning

confidence: 99%

Patient and Caregiver Determinants of Patient Quality of Life and Caregiver Strain in Left Ventricular Assist Device Therapy

Bidwell

Lyons

Mudd

et al. 2018

JAHA

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“…Three steps were used to identify distinct patterns of dyadic mental health among lung cancer partner‐care partner dyads using an integrative approach described previously . First, multilevel modeling was used to generate empirical Bayes estimates of dyadic mean health (ie, average level of mental health within the dyad) and dyadic difference in health (ie, gap in mental health between patient and care partner) for each wave of data collection to control for interdependencies in the dyadic data and autocorrelations over time .…”

Section: Methodsmentioning

confidence: 99%

Patterns, relevance, and predictors of dyadic mental health over time in lung cancer

Lee

Lyons

2019

Psycho-Oncology

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Objective To identify distinct patterns of dyadic mental health in a sample of lung cancer dyads over 12 months and associations with other health characteristics and individual, dyadic, and familial predictors. Methods A sample of 113 patient‐care partner dyads living with nonsmall cell lung cancer were examined five times over 12 months. An integrative multilevel and mixture modeling approach was used to generate dyadic mental health summaries and identify common dyadic patterns of mental health over time, respectively. Results Three distinct patterns of dyadic mental health were observed: a congruent pattern (32.7%) characterized by almost identical mental health between members of the dyad, a disparate pattern (29.2%) characterized by better mental health of the patient compared with the care partner, and a parallel pattern (38.1%) characterized by care partner patterns of improvement and greater similarity in mental health over time. Membership of patterns was associated with physical health characteristics of both patient and care partner, levels of patient concealment regarding worries and concerns, and relationship quality reported by the care partner. Patterns did not differ by patient gender, care partner strain, or levels of social support. Conclusions Findings emphasize the importance of examining patterns of dyadic mental health to identify dyads most at risk so we may optimize the health of the dyad in tailored ways.

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“…To identify configurations of shared HF knowledge in patient-caregiver dyads, we used a two-step process involving both dyadic multilevel and latent class approaches. 9,36 It should be noted that this analysis is exploratory, as limited research in dyadic HF knowledge precluded a priori effect size estimation, and power analysis in latent class modeling is heavily dependent on anticipated classes. However, latent class analysis in HF family care dyads has been done successfully with samples substantially smaller than 100 dyads.…”

Section: Methodsmentioning

confidence: 99%

Shared heart failure knowledge and self-care outcomes in patient-caregiver dyads

et al. 2018

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Patterns, relevance and predictors of heart failure dyadic symptom appraisal

Abstract: Differences in how HF patients and caregivers appraise symptoms together must be taken into consideration when examining contributions to HF care and caregiver outcomes.

Cited by 36 publications

References 45 publications

Patient and Caregiver Determinants of Patient Quality of Life and Caregiver Strain in Left Ventricular Assist Device Therapy

Patient and Caregiver Determinants of Patient Quality of Life and Caregiver Strain in Left Ventricular Assist Device Therapy

Patterns, relevance, and predictors of dyadic mental health over time in lung cancer

Shared heart failure knowledge and self-care outcomes in patient-caregiver dyads

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