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Caregiver preparedness has an important role in improving caregiver contributions to self-care in adults with heart failure

Session Oral session - Chronic Heart Failure

Speaker Antonio Petruzzo

Event : EuroHeartCare 2019

  • Topic : heart failure
  • Sub-topic : Treatment
  • Session type : Abstract Sessions

Authors : A Petruzzo (Rome,IT), V Biagioli (Rome,IT), M Tomietto (Oulu,FI), R Alvaro (Rome,IT), E Vellone (Rome,IT)

Authors:
A Petruzzo1 , V Biagioli2 , M Tomietto3 , R Alvaro4 , E Vellone4 , 1San Camillo Forlanini Hospital, Cardiovascular department - Rome - Italy , 2Bambino Gesu Childrens Hospital - Rome - Italy , 3University of Oulu, Nursing Science and Health Management Unit - Oulu - Finland , 4University of Rome Tor Vergata, Biomedicine and prevention - Rome - Italy ,

Topic(s):
Chronic Heart Failure – Treatment

Background/Introduction
Informal caregivers, such as family members, provide a huge contribution to self-care in patients with heart failure (HF). Higher the Caregiver Contribution (CC) to HF self-care, lower HF patients’ mortality. Caregiver preparedness is the perceived preparation to take care both for physical and emotional needs of the care recipient. To the extent of our knowledge, no study has evaluated how caregiver preparedness could improve CC to HF self-care.

Purpose
The aim of this study was to test the role of caregiver preparedness on CC to HF self-care. Specifically, the following hypotheses were tested: 1) caregiver preparedness influences CC; 2) caregiver confidence influences CC to HF self-care maintenance and management; and, 3) caregiver confidence mediates the relationship between preparedness and CC to self-care maintenance and management.

Methods
Caregivers were recruited in Italy, both in outpatient and hospital settings. Caregiver Preparedness Scale and the Caregiver Contribution to Self-Care of Heart Failure Index were adopted to measure HF caregiver preparedness and CC to HF self-care, respectively. Descriptive statistics, correlations, and a path analysis model were performed to test the hypothesis. The model was adjusted using the following variables: patient and caregiver socio-demographic data and patient comorbidities and cognition. Indirect and direct effects of preparedness on CC self-care maintenance and CC self-care management were estimated as implemented in Mplus7. Mediation effects were tested performing the Sobel test.

Results
366 HF caregivers were enrolled in the study: they were mostly female (73.3%) and partnered (69.6%), with a high education level (66.4%). Patients were older than caregivers (71.9, SD 12.7 vs. 58.6, SD 15.7, respectively), and predominantly in NYHA class II (61.3%). The hypothesized model showed a good fit to the data: ?2(Chi Square) = 24.117 (14) p = 0.044; CFI = 0.968; TLI = 0.921; RMSEA = 0.052; SRMR=0.035. The model verified all the study hypotheses: higher caregiver preparedness was associated with higher CC (1); higher CC to self-care confidence was associated with higher CC to self-care maintenance and management (2); and, finally, caregiver confidence fully mediated the relationship between preparedness and CC to self-care maintenance and management (3).

Conclusions
As hypothesized, caregiver preparedness influences CC to self-care maintenance and management and caregiver confidence is the mechanism by which caregiver preparedness influences CC to self-care. By improving informal caregivers’ preparedness and confidence in HF care, it is possible to enhance CC toHF self-care and, definitely, to increase HF patient safety outcomes.

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