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Family Caregiving in Heart Failure

Bakas, Tamilyn; Pressler, Susan J.; Johnson, Elizabeth A.; Nauser, Julie A.; Shaneyfelt, Terrence

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Background: Little is known about the experiences of family caregivers of patients with heart failure, despite the fact that these patients have disabling symptoms and diminished functioning that could lead to caregiver stress.

Objectives: Based on a caregiver model, the aims of this study were to (a) examine relationships among age, perceived control over managing heart problems, perceived difficulty with tasks, perceived outcomes, and perceived mental and general health among caregivers of persons with heart failure; (b) describe caregivers' perceptions of control over managing heart problems; and (c) describe the tasks and outcomes perceived as being most difficult and negative by caregivers.

Methods: A sample of 21 family caregivers of patients with heart failure completed the study questionnaires. Most were women (n = 20), spouses (n = 20), and White (n = 18), with a mean age of 59.6 years. The patients with heart failure were male veterans with New York Heart Association (NYHA) Class II, III, or IV. Descriptive statistics and Spearman's ρ correlations were used.

Results: Younger caregivers perceived their tasks to be more difficult and their mental health to be poorer. Caregivers' perceived control over managing heart problems was related moderately to poorer perceived mental health. Greater perceived difficulty with tasks was associated with negative perceptions of caregiver outcomes and poorer perceived mental health. Negative perceptions of caregiver outcomes were associated strongly with perceptions of poorer mental health. Performing household tasks and managing patient behaviors were most difficult, and the caregiver's emotional and financial well-being, time for social activities, and general health had deteriorated.

Conclusions: The preliminary results support the model. Future longitudinal studies are needed in larger samples to evaluate predictors of caregiver-perceived negative outcomes to identify priority areas for interventions.

Tamilyn Bakas, DNS, RN, is Associate Professor; Susan J. Pressler, DNS, RN, FAAN, FAHA, is Professor; Elizabeth A. Johnson, MSN, APRN, BC, is PhD Student; and Julie A. Nauser, MSN, RN, is PhD Candidate, Indiana University School of Nursing, Indianapolis. Terrence Shaneyfelt, MD, MPH, is Chief, General Medicine, Veterans Administration, Birmingham, Alabama.

Accepted for publication February 14, 2006.

The study was supported by VA HSR&D Funding CPI99124-1. Thank you to Phyllis Dexter, PhD, RN, Editor, Indiana University School of Nursing Center for Research, for editorial assistance.

Corresponding author: Tamilyn Bakas, DNS, RN, FAHA, Indiana University School of Nursing, 1111 Middle Drive, NU417, Indianapolis, IN 46202-5107 (e-mail: tbakas@iupui.edu).

© 2006 Lippincott Williams & Wilkins, Inc.