The Influence of Mutuality on Self-Care in Heart Failure Patients and Caregivers: A Dyadic Analysis

Ercole Vellone, Misook L. Chung, Rosaria Alvaro, Marco Paturzo, Federica Dellafiore

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


Mutuality in patient–caregiver dyad may improve heart failure (HF) patient self-care and caregiver contribution to self-care, but literature is scarce. We evaluated the influence of mutuality and its dimensions on patient–caregiver dyad self-care. A sample of 366 HF patient–caregiver dyads was enrolled. The Actor–Partner Interdependence Model was used to identify the influence of individual patient and caregiver mutuality on their own self-care (actor effect) and on partner self-care (partner effect). The total mutuality score had an actor effect on patient self-care maintenance (i.e., behaviors aimed at maintaining HF stability) and on patient and caregiver self-care confidence. Total score of patient mutuality also had a partner effect on caregiver self-care management (i.e., responses to symptoms of HF exacerbation). Specific mutuality dimensions had different actor and partner effects on patient and caregiver self-care. Interventions to improve mutuality in HF patient–caregiver dyads may influence patient self-care and caregiver contribution to self-care.

Original languageEnglish
Pages (from-to)563-584
Number of pages22
JournalJournal of Family Nursing
Issue number4
StatePublished - Nov 1 2018

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Center of Excellence for Nursing Scholarship, Rome, Italy. The authors acknowledge the support received in this study by the Italian Association of Heart Failure Patients (Associazione Italiana Scompensati Cardiaci—AISC).

Publisher Copyright:
© The Author(s) 2018.


  • heart failure
  • mutuality
  • patient–caregiver dyads
  • self-care

ASJC Scopus subject areas

  • Community and Home Care
  • Family Practice


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