Shared Care Dyadic Intervention

Abstract

Up to half of heart failure (HF) patients are readmitted to hospitals within 6 months of discharge. Many readmissions are linked to inadequate self-care or family support. To improve care, practitioners may need to intervene with both the HF patient and family caregiver. Despite the recognition that family interventions improve patient outcomes, there is a lack of evidence to support dyadic interventions in HF. Thus, the purpose of this study was to test the Shared Care Dyadic Intervention (SCDI) designed to improve self-care in HF. The theoretical base of the SCDI was a construct called Shared Care. Shared Care represents a system of processes used in family care to exchange support. Key findings were as follows: the SCDI was acceptable to both care partners and the data supported improved shared care for both. For the patient, there were improvements in self-care. For the caregivers, there were improvements in relationship quality and health.

Family Context Influences Psychological Outcomes of Depressive Symptoms and Emotional Quality of Life in Patients With Heart Failure

“…Second, the greater level of perceived control by the FMs may increase their ability to provide a higher level of support to the patient with HF. Although the research is limited concerning the association of FM knowledge and level of depressive symptoms in chronically ill patients, our findings were consistent with Sebern and Woda 35 who found that higher levels of depressive symptoms in patients with HF were associated with lower levels of FM knowledge and ineffective family functioning. 35 …”

Family caregiving for persons with heart failure at the intersection of heart failure and palliative care: a state-of-the-science review

“…Ten studies had a randomized controlled trial design [25, 26, 62, 89, 100, 101, 110, 112, 126, 130] and six were quasi-experimental, non-randomized designs [50, 55, 58, 107, 111, 129]. Sample sizes ranged from 11 to 369 caregivers, though the majority (n=11) had less than 70 caregiver participants, including 5 of the 10 randomized trials.…”

“…Outcomes were followed up to 24 months after baseline. Most studies applied a dyadic approach involving both the patient and caregiver in the intervention [25, 26, 55, 58, 101, 110, 111, 126, 129, 130], while others focused solely on the caregiver [50, 62, 89, 100, 110]. Five interventions [25, 26, 50, 100, 130] involved individual nurse-led face-to-face psychoeducational sessions sometimes in combination with other approaches to follow-up such as home visits [25, 100], telemonitoring [50] and telephone calls [100, 130].…”

“…Two studies employed a support group format; one led by a nurse (4 sessions) [62] and the other by a member of a multidisciplinary team (6 sessions) [89]. Two other studies [55, 129] tested interventions consisting of in-person psycho-educational and skill-building small group sessions involving caregivers and patients, both together and separately in different sessions. One study tested whether an exercise intervention for patients impacted caregiver outcomes without there being a specific intervention component for the caregiver [101].…”

Problems Experienced in the Second and Third Months After Discharge From a Heart Failure-Related Hospitalization

“…23 For example, family-based approaches that focus on coping and communication, problem-solving, and managing stress and negative emotions have shown promise, although evidence is limited. 28,29 Individuals with heart failure continue to experience problems in the home during the second and third months post-hospital discharge. Although treatment regimen and HF symptoms remained a high priority, new or more prevalent problems such as comorbidities, difficulty coping, and depleted resources emerged.…”