Family caregivers of patients with heart failure: a longitudinal study.

BACKGROUND: The family caregivers of patients with heart failure (HF) report burden and poor quality of life, but little is known about changes in their perceptions over time. OBJECTIVES: The aims of this study were (1) to evaluate changes in caregiver burden (perceived time spent and difficulty with caregiving tasks), perceived control, depressive symptoms, anxiety, perceived life changes, and physical and emotional health-related quality of life; (2) to determine differences in perceptions between caregivers of patients with low HF symptoms (New York Heart Association class I and II) and caregivers of patients with high HF symptoms (New York Heart Association class III and IV); and (3) to the estimate time spent performing caregiving tasks. METHODS: Sixty-three HF patients and 63 family caregivers were enrolled; 53 caregivers completed the longitudinal study. Data were collected from medical records and interviews conducted by advanced practice nurses at baseline and 4 and 8 months later. RESULTS: Caregivers who completed the study had significant improvements in perceived time spent on and difficulty of caregiving tasks from baseline to 4 and 8 months, and depressive symptoms decreased from baseline to 8 months. Perceived life changes resulting from caregiving became more positive from baseline to 4 and 8 months. Perceived control, anxiety, and health-related quality of life did not change. Compared with caregivers of patients with low symptoms, caregivers of patients with high symptoms perceived that they spent more time on tasks and that tasks were more difficult, had higher anxiety, and had poorer physical health-related quality of life. Estimated time in hours spent providing care was high. CONCLUSIONS: In this sample, perceptions of the caregiving experience improved over 8 months. Health-related quality of life was moderately poor over the 8 months. Caregivers of patients with more severe HF symptoms may be particularly in need of interventions to reduce time and difficulty of caregiving tasks and improve physical health-related quality of life.

Family caregiver outcomes in heart failure.

BACKGROUND: Family caregivers of patients with heart failure report high stress, burden, and poor emotional and physical health, but less is known about predictors of health among these caregivers. OBJECTIVES: To determine predictors of family caregiving outcomes among caregivers of patients with heart failure and to identify the tasks reported as most difficult and the most negative outcomes. METHODS: A total of 63 patients with heart failure and their 63 family caregivers were enrolled in this prospective study. Data were collected from medical records and from interviews conducted at baseline and 4 and 8 months later. RESULTS: Caregivers reported moderately poor physical and emotional health-related quality of life. Those with more depressive symptoms at baseline were more likely to report their lives had changed for the worse at 4 months (P=.03). The caregivers' medical health condition (P<.001) and perceived difficulty of caregiving tasks (P=.04) were predictors of physical health-related quality of life at 4 months; at 8 months, medical health condition was the only predictor (P=.004). At 4 and 8 months, depressive symptoms were predictors of emotional health-related quality of life (P<.001 and P=.001, respectively). The most difficult caregiving tasks were those dealing with patients' behavior problems; the most negative outcome was having less time for activities with friends. CONCLUSIONS: Studies are needed in larger samples to identify needs of vulnerable populations of caregivers of patients with heart failure and to develop and test interventions for improving caregivers' outcomes.