Caregiver contribution to heart failure patient self-care does not increase caregiver burden

Background: HF affects patient outcomes with repeated hospitalisations, poor quality of life and increased mortality rates. Self-care, which is the process that HF patients use to maintain the stability of the disease and to respond to symptoms when they occur, can improve HF outcomes. However, in several populations, HF patient self-care was found to be insufficient. Caregiver contribution (CC) to HF patient self-care improves patient outcomes but could be burdensome for caregivers. To our knowledge, no study has yet evaluated if CC to HF patient self-care is burdensome for caregivers. Purpose: To evaluate if CC to HF self-care increases caregiver burden over and above caregiver and patient characteristics. Methods: A secondary analysis of a cross-sectional study in which we enrolled 505 caregivers of HF patients in 28 provinces across Italy. Caregivers were defined as those persons inside or outside the family who provided most of the informal care to HF patients. In the data analysis we considered: the CC to Self-Care of Heart Failure Index scores; the Caregiver Burden Inventory scores; caregiver characteristics (i.e. age, gender, employment, education level, living with the patient, hours of caregiving per day, social support); and patient characteristics (i.e. age, gender, employment, education level, hospitalisation for HF in previous year, ejection fraction, New York Heart Association [NYHA] class, months of illness, number of medications taken, comorbidities, cognitive impairment and physical and mental quality of life). We used hierarchical regression to evaluate if the scores for the CC to Self-Care of Heart Failure Index predicted Caregiver Burden Inventory scores over and above the caregiver and patient characteristics. Results: The caregivers were 56.5 years old ( 14.9) on average, and they were mostly females (52.5%) or the patients spouses or adult children (82.4%). HF patients were 75.9 years old ( 10.4) on average, and they were mostly males (55.2%). The only caregiver predictor of higher caregiver burden was older age; patient predictors of higher caregiver burden were older age, higher education, a fewer number of medications taken and lower mental quality of life (R2 = 0.25). At the hierarchical regression, CC to Self-Care of Heart Failure Index scores were not significant predictors of caregiver burden. Conclusions: While HF caregiver and patient characteristics were predictors of caregiver burden, CC to self-care was not. Since CC to HF self-care improves patient outcomes and is not burdensome for caregivers, providers may consider educating caregivers about self-care as a viable option for improving patient outcomes without increasing caregiver burden. However, further research is needed to confirm the results of this study.