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Caregivers’ Heart Failure Knowledge Is Necessary but Not Sufficient to Ensure Engagement With Patients in Self-care Maintenance

Buck, Harleah G. PhD, RN, FPCN, FAAN; Hupcey, Judith EdD, CRNP, FAAN; Mogle, Jacqueline PhD; Rayens, Mary Kay PhD

Journal of Hospice & Palliative Nursing: April 2017 - Volume 19 - Issue 2 - p 170–176
doi: 10.1097/NJH.0000000000000326
Feature Articles

The chronic illness literature suggests that patient–informal caregiver dyads who are relationally oriented (share decisions and activities) are more efficient and effective than those who are not. But this is currently unknown in heart failure (HF). Our aim was to examine differences between individually and relationally oriented HF dyads relative to patient symptom management scores. This was a cross-sectional study of 55 dyads (spousal/adult child/relative) analyzed using Actor-Partner Interdependence Model techniques. Dyad orientation was measured by the Dyadic Symptom Management Type scale, and symptom management by Self-care of HF Index. On average, patients were older, white males with younger, female caregivers. Whether the dyads were individually oriented or relationally oriented did not make a difference. However, dyads’ agreement on that orientation and the caregivers’ HF-related knowledge impacted caregiver engagement in self-care maintenance or adherence and monitoring behaviors. It is assumed that caregivers will engage in HF care. Our study suggests that caregivers will engage if they agree with the patient on who is providing that care and are knowledgeable. The Dyadic Symptom Management Type scale is a 1-item question that can be administered in the clinical setting by a palliative care nurse in less than 2 minutes to assess agreement and target teaching.

Harleah G. Buck, PhD, RN, FPCN, FAAN, is associate professor, coordinator of Chronic Illness Initiatives, College of Nursing, University of South Florida, Tampa.

Judith Hupcey, EdD, CRNP, FAAN, is associate dean for Graduate Education and Research, professor of nursing, Penn State University, State College, Pennsylvania.

Jacqueline Mogle, PhD, is assistant professor, College of Nursing, Penn State University, State College, Pennsylvania.

Mary Kay Rayens, PhD, is professor, College of Nursing, University of Kentucky, Lexington.

Address correspondence to Harleah G. Buck, PhD, RN, FPCN, FAAN, College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd MDC22, Tampa, FL 33612 (

Research reported in this presentation was supported by the National Institute of Nursing Research of the National Institutes of Health under award R03NR014524.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors have no conflicts of interest to disclose.

© 2017 by The Hospice and Palliative Nurses Association.