Shared heart failure knowledge and self-care outcomes in patient-caregiver dyads.
Julie T Bidwell, Melinda K Higgins, Carolyn M Reilly and 2 others
PMID 29153759WHAT IT FOUND
Heart failure patient-caregiver pairs with a knowledge gap were 71% less likely to meet a strict low-sodium diet.
Medication adherence was not shown to be lower.
Key findings
01Two dyadic knowledge patterns were identified: 85 dyads had higher shared knowledge and a smaller patient-caregiver difference, and 29 had lower shared knowledge and a larger difference.
02In adjusted models, the knowledge-gap group was 71% less likely to adhere to a stringent low-sodium diet, but lower medication adherence was not significant.
03Patients usually had higher heart failure knowledge than their caregivers.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a baseline cross-sectional analysis from a trial, not a test of whether education improves self-care. The sample was only 114 dyads, and the knowledge-group analysis was exploratory. The association with medication adherence was not significant after adjustment. The study could not show that poor knowledge caused poor adherence. The sodium cut-off used here is debated, so the dietary finding may depend on that choice. The sample had relatively homogeneous clinical characteristics, so other patient-caregiver knowledge patterns may exist.
Declared interests
No conflicts of interest were declared.
The easy way to misread this
Do not conclude that improving patient or caregiver knowledge will improve heart failure self-care. This analysis was cross-sectional baseline data, and the adjusted medication adherence association was not significant (p = 0.08).