Caregivers' Contributions to Heart Failure Self-care: An Updated Systematic Review.
Harleah G Buck, Chelsea Howland, Michael A Stawnychy and 12 others
PMID 38306302WHAT IT FOUND
Informal caregivers do far more than hands-on tasks.
They manage appointments, monitor symptoms via technology, and navigate systems. These 'hands-off' roles are critical but often invisible, requiring clinicians to consult caregivers on feasibility before prescribing self-care plans.
Key findings
01Caregivers contribute to self-care through both 'hands-on' tasks (e.g., medication administration) and 'hands-off' tasks (e.g., system navigation, emotional support), with hands-off activities comprising the majority of contributions in maintenance domains.
02Self-care monitoring has shifted toward technology-assisted 'hybrid' activities, where caregivers use telehealth and apps to track symptoms, blurring the line between direct and indirect care.
03Significant gaps exist in the literature, including a lack of specific data on time spent, emotional support, and the impact of caregiving on employment, meaning current models may undervalue this 'hidden work'.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review excluded paid caregivers and studies using only summative caregiving scales, which may limit the generalizability to professional care settings. Many included studies lacked specificity in defining activities, making it difficult to quantify the exact time or effort involved. The meta-synthesis approach relies on qualitative interpretation, which can introduce researcher bias. Studies with some risk of bias were retained to be inclusive, potentially affecting the certainty of specific findings.
Declared interests
The authors declare no conflicts of interest. The work was supported by the National Institute of Nursing Research (NINR) and the National Institute of Biomedical Imaging and Bioengineering (NIBIB) of the National Institutes of Health.
The easy way to misread this
Do not assume that 'hands-on' clinical tasks are the primary measure of caregiver contribution. The review found that 'hands-off' activities like system navigation and emotional support are more frequent and critical, yet often invisible in standard care planning.