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

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.