The key role of caregiver confidence in the caregiver's contribution to self-care in adults with heart failure

Background: Caregivers play an important role in contributing to heart failure (HF) patients' self-care but no prior studies have examined the caregivers' contributions to HF patients' self-care and no prior studies have examined potential determinants of the caregivers' contribution to HF patients' self-care. Aims: The purpose of this study was to describe the caregivers' contribution to HF patients' self-care and identify its determinants. Methods: The study design involved a secondary analysis of cross-sectional data. Caregivers' contributions were measured with the Caregiver's Contribution to Self-care of HF Index (CC-SCHFI) which measures the caregiver's contribution to self-care maintenance and management and caregiver confidence in contributing to HF patient's self-care. Potential determinants were measured using a socio-demographic questionnaire completed by caregivers and patients, and patient clinical data was obtained from the medical record. Results: Data from 515 caregiver/patient dyads were analyzed. Most (55.5%) patients were male (mean age 75.6 years) and most (52.4%) caregivers were female (mean age, 56.6 years). The caregivers' contribution to patients' self-care maintenance was low in weight monitoring and physical activity but higher in checking ankles, advising on low-salt foods and taking medicines. The caregivers' contribution to patients' self-care management was low in symptom recognition. When symptoms were recognized, caregivers advised patients to reduce fluids and salt and call the provider but rarely advised to take an extra diuretic. Caregiver confidence in the ability to contribute to patient self-care explained a significant amount of variance in the caregiver's contribution. Conclusion: These findings suggest that caregivers in this sample did not contribute meaningfully to HF self-care. Providers should educate both HF patients and caregivers. Interventions that improve caregiver confidence have the potential to successfully increase the caregivers' contribution to patients' self-care.