Profiles of Dyadic Self-care Congruence and Patient Symptom Burden in Heart Failure.
Giulia Locatelli, Ercole Vellone, Davide Ausili and 1 others
PMID 40778785WHAT IT FOUND
Heart failure patients whose caregivers contributed more to self-care reported the highest physical symptom burden.
Patients who performed more self-care than their caregivers reported the lowest. This describes patterns, not proof that self-care lowers symptoms.
Key findings
01Among 510 dyads, three classes emerged: caregivers contributed more (17%), patients performed more (7%), and both contributed similarly (76%).
02Symptom burden was highest in the caregiver-contributed-more class (mean 36.258 on a 0-90 scale) and lowest in the patient-performed-more class (mean 26.738).
03Caregivers in the patient-performed-more class tended to have greater anxiety and depression and lower quality of life, though differences were not always significant.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis used baseline data only, so it cannot show how dyads change over time or whether self-care patterns cause symptom burden. Patients were selected for poor self-care and were mainly New York Heart Association class II to III, so results may not apply to patients with better self-care or class IV disease. The model had classification uncertainty (entropy 0.71), so some dyads may be placed imperfectly into classes. Some differences, especially caregiver anxiety, depression, and quality of life in class 2, were not always statistically significant. This is a secondary analysis of a randomized trial, but it does not report the trial intervention effect.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that increasing patient self-care will reduce symptom burden. The data are cross-sectional, and the classes differ in age, comorbidities, mood, and quality of life, so the observed pattern may reflect who is too unwell to self-care rather than self-care causing lower symptoms.