Patterns of Heart Failure Dyadic Illness Management: The Important Role of Gender

J Cardiovasc Nurs. 2020 Sep/Oct;35(5):416-422. doi: 10.1097/JCN.0000000000000695.

Abstract

Background: The ways in which patients with heart failure (HF) and their care partners work together to manage HF are often overlooked.

Objective: The aim of this study was to identify and compare different patterns of HF dyadic illness management.

Methods: This was a secondary analysis of data on HF dyads. Heart failure management was measured using patient and care partner versions of the Self-Care of HF Index and European HF Self-care Behavior Scale. Latent class modeling was used to identify patterns of HF dyadic management.

Results: The mean age of the 62 patients and their care partners was 59.7 ± 11.8 and 58.1 ± 11.9 years, respectively. A majority of patients (71.0%) had class III/IV HF, and a majority of the couples (95.2%) were married. Two distinct dyadic patterns were observed, 1 collaborative management type (n = 42, 67.7%) and 1 autonomous management type (n = 20, 32.3%). Dyads in the autonomous pattern were mostly female patients with male care partners; patients in this pattern also were more anxious and depressed, and reported worse relationship quality compared with collaborative dyads.

Conclusion: There is an engendered spectrum of collaboration in how HF patient-care partner dyads work together to manage HF that needs to be considered in clinical care and research.

MeSH terms

  • Anxiety / etiology
  • Caregivers / psychology*
  • Depression / etiology
  • Disease Management*
  • Female
  • Heart Failure / therapy*
  • Humans
  • Male
  • Middle Aged
  • Self Care*