Abstract 15239: Patient Self-Care Mediates the Relationship Between Caregiver Contributions and Symptom Burden in Heart Failure

Introduction: Patients with heart failure (HF) experience high symptom burden that can be mitigated with adequate self-care. The situation-specific theory of caregiver contribution to HF self-care suggests that caregivers have a key role in improving patient symptom burden.

Hypothesis: a) caregiver contribution to self-care influences patient self-care; b) patient self-care influences symptom burden; c) patient self-care mediates the relationship between caregiver contribution to self-care and symptom burden.

Methods: Secondary analysis of baseline and three-months data from the MOTIVATE-HF trial, which enrolled 510 HF patient-caregiver dyads in Italy. Data were collected using the Self-Care of HF Index v.6.2, the Caregiver Contribution to Self-Care of HF Index, and the HF Somatic Perception Scale. Autoregressive longitudinal path analysis with contemporaneous mediation was used to test study hypotheses.

Results: On average, caregivers were 54 ± 15.46 years and mainly female (74.5%), while patients were 72.4 ± 12.28 years and mainly male (68%). Better caregiver contribution to self-care maintenance was associated with better patient self-care maintenance (β=0.280, p<0.001), which, in turn, was associated with lower symptom burden (β=-0.280, p<0.001). Patient self-care maintenance mediated the effect of caregiver contribution to self-care maintenance on symptom burden (β=-0.079, 95% BC bootstrapped CI: -0.130, -0.043). Better caregiver contribution to self-care management was associated with better patient self-care management (β=0.238, p=0.006). The model accounted for 37% of the variance in symptom burden (p<0.001).

Conclusions: Targeting caregivers to increase their contribution to self-care can increase patient self-care and, consequently, lower patients’ HF symptom burden.