The impact of informal caregivers’ preparedness on short-term outcomes of heart failure patients with insufficient self-care

• Published in: European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology 2023-09, Vol.22 (6), p.628-637
• Main Authors: Cheng, Ming, Zhu, Chenya, Ge, Yingying, Ke, Yufei, Shi, Yixing, Su, Yue, Ma, Tianyu, Chi, Meixuan, Wang, Naijuan, Lu, Bingqing, Hou, Yunying
• Format: Article
• Language: English
• ISSN: 1474-5151; 1873-1953
• DOI: 10.1093/eurjcn/zvac102

Abstract Aims Even though self-care is essential in the long-term management of heart failure (HF), it is often not performed adequately in HF populations. Mobilizing informal caregivers may be one way to help patients perform self-care, support individual needs, and maintain health. However, informal caregivers often face insufficient preparation for providing long-term care. This insufficient caregiver preparedness may lead to a decline in caregiver contributions and affect the outcomes of care in patients with HF. This study aimed to explore whether informal caregivers’ preparedness is a predictor that influences short-term outcomes of HF patients; to analyse whether caregiver contribution to self-care of HF (CC-SCHF) plays a mediating role between informal caregivers’ preparedness and HF short-term outcomes. Methods and results A prospective observational study was conducted in China. After controlling for covariates, higher levels of informal caregivers’ preparedness were significantly associated with lower 3-month mortality [odds ratio (OR) = 0.919, 95% confidence interval (CI) = (0.855–0.988), P = 0.022] and 3-month readmission rate [OR = 0.883, 95% CI = (0.811–0.961), P = 0.004] and shorter length of hospital stay (β = −0.071, P < 0.001). The informal caregiver’s preparedness was positively associated with CC-SCHF maintenance (r = 0.708, P < 0.01), CC-SCHF management (r = 0.431, P < 0.01), and CC-SCHF confidence (r = 0.671, P < 0.01). The CC-SCHF management was a mediator in the relationship between informal caregivers’ preparedness and 3-month readmission rate [effect 95% CI = (−0.054 to −0.001)] and length of hospital stay [effect 95% CI = (−0.235 to −0.042)]. Conclusion A higher level of informal caregivers’ preparedness is associated with better short-term outcomes of HF patients with insufficient self-care. Graphical Abstract Graphical Abstract