The Influence of Preparedness, Mutuality, and Self-efficacy on Home Care Workers' Contribution to Self-care in Heart Failure

Abstract

Background: Home care workers (HCWs) are increasingly caring for patients with heart failure (HF). Previous studies have shown that they contribute to HF patients' care, but how their preparedness and their relationship with patients (mutuality) influence caregiving is unknown, as well as the role of HCWs' self-efficacy. Objective: Guided by the Situation-Specific Theory of Caregiver Contribution to HF Self-Care, we investigated the influence of HCWs' preparedness and mutuality on HCWs' contribution to HF self-care and the mediating effect of HCWs' self-efficacy in the process. Methods: We conducted a cross-sectional survey of HCWs who cared for patients with HF. The survey included the Caregiver Preparedness Scale, Mutuality Scale, Caregiver Contribution to Self-Care of HF Index, and Caregiver Self-Efficacy in Contributing to Self-Care Scale. We performed structural equation modeling and a mediation analysis. Results: A total of 317 HCWs employed by 22 unique home care agencies across New York, NY, completed the survey. They had a median age of 50 years, 94% were women, and 44% were non-Hispanic Black. Results demonstrated that mutuality had a direct influence on HCW contribution to self-care and preparedness influenced their contribution to self-care, but only through the mediation of self-efficacy. Conclusion: Home care workers' preparedness, mutuality, and self-efficacy have important roles in influencing their contribution to HF self-care. As a workforce increasingly involved in the care of patients with HF, knowing the mechanisms underpinning HCWs' contribution to self-care may illuminate future interventions aimed at improving their contributions and HF patient outcomes.

Protective Role of Caregiver Preparedness on the Relationship Between Depression and Quality of Life in Stroke Dyads

“…For example, better caregiver preparedness has been associated with lowered caregiver burden, less strain, and mood disturbances 20,21 and better contributions to self-care. 22 Better caregiver preparedness has also been associated with better patient outcomes, such as lower risks for hospital readmission, 23 higher QOL, and better recovery. 24,39 However, in this study, we identified a new role for caregiver preparedness as a moderator.…”

“…Prior studies conducted on other health conditions have shown that better caregiver preparedness is associated with improved outcomes not only for caregivers but also for patients. For example, researchers have observed that caregivers with better caregiver preparedness have a lower burden, less strain, and mood disturbances 20,21 and contribute better to self-care 22 ; regarding patients, better caregiver preparedness has been shown to be associated with lower risks of hospital readmission, 23 higher QOL, and better recovery. 24 Prior studies have also shown that caregiver preparedness can be easily modified with interventions.…”

Forgotten Front Line: Understanding the Needs of Unionized Home Health Aides in Downstate New York During the COVID-19 Pandemic

“…We chose a minimal sample size of 250 based on the capacity of the participating organizations and what was determined to be a minimum number of responses for drawing some general conclusions about the experience of this worker population. 11,12…”

Utilization, Contributions, and Perceptions of Paid Home Care Workers Among Households in New York State

“…Other qualitative studies have found the same, including a study of family caregivers by Shaw et al ( 20 ) which found that paid home care workers often provided patients with functional and emotional support. Similarly, a recent survey by Sterling et al ( 7 ) of over 300 paid home care workers found that nearly two thirds contribute to their patients’ heart failure self-care activities, such as assisting with the preparation of low salt meals, reminding patients to take medication, and engage in physical activity. Our study expands these qualitative findings by quantitatively documenting the contributions of paid home care workers from the care recipients’ perspective.…”

“…We used Poisson regression because with frequent outcomes, prevalence ratios (PRs) are less likely to be overestimated and are easier to interpret than odds ratios ( 17 ). Characteristics were selected for the model based on previous literature ( 7 ) or a significant bivariate association ( p < .05) with type of care. We repeated this process for the remaining outcome of experience with a paid home care worker.…”