University of Oulu

Vellone, Ercole PhD, RN, FESC; Biagioli, Valentina PhD, RN; Durante, Angela PhD, RN; Buck, Harleah G. PhD, RN, FPCN, FAAN; Iovino, Paolo MSN, RN; Tomietto, Marco PhD, RN; Colaceci, Sofia PhD, BMid; Alvaro, Rosaria MSN, RN, FESC, FAAN; Petruzzo, Antonio PhD, RN The Influence of Caregiver Preparedness on Caregiver Contributions to Self-care in Heart Failure and the Mediating Role of Caregiver Confidence, The Journal of Cardiovascular Nursing: 5/6 2020 - Volume 35 - Issue 3 - p 243-252 doi: 10.1097/JCN.0000000000000632

The influence of caregiver preparedness on caregiver contributions to self-care in heart failure and the mediating role of caregiver confidence

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Author: Vellone, Ercole1; Biagioli, Valentina2; Durante, Angela1;
Organizations: 1Department of Biomedicine and Prevention, University of Rome “Tor Vergata,” Italy
2Department of Medicine and Psychology, University of Rome “La Sapienza,” Italy
3College of Nursing, University of South Florida, Florida
4Department of Biomedicine and Prevention, University of Rome “Tor Vergata,”Italy
5Australian Catholic University, Melbourne
6Research Unit of Nursing Science and Health Management, University of Oulu, Finland
7Azienda per l'Assistenza Sanitaria n. 5 “Friuli Occidentale”, Pordenone, Italy
8Saint Camillus International University of Health Sciences, Rome, Italy
9San Camillo Hospital, Rome, Italy
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.8 MB)
Persistent link:
Language: English
Published: Wolters Kluwer, 2020
Publish Date: 2021-05-01


Background: Caregiver contributions (CC) to heart failure (HF) self-care maintenance (ie, CC to maintaining HF stability) and management (ie, CC to dealing with HF signs and symptoms) improve patient outcomes, but it is unknown whether caregiver preparedness influences CC to self-care and whether caregiver confidence mediates this process.

Objectives: We evaluated the influence of caregiver preparedness on CC to HF self-care maintenance and management and the mediating role of caregiver confidence.

Methods: This is a secondary analysis of the MOTIVATE-HF study. Patients were 18 years or older, with a diagnosis of HF in New York Heart Association classes II to IV, who had insufficient self-care and did not have severe cognitive impairment. Patients’ informal caregivers were those people inside or outside the family who gave most of the informal care to the patients. We used the Caregiver Preparedness Scale and the Caregiver Contribution to Self-Care of HF Index. We tested a path analysis model and the indirect effects.

Results: Caregivers (n = 323) were 55 (SD, 15) years old on average and predominantly female (77%). The path analysis showed that higher scores in caregiver preparedness were associated with higher scores in caregiver confidence. In turn, higher caregiver confidence was associated with higher CC to self-care maintenance and management. Caregiver confidence mediated the association between caregiver preparedness and CC to self-care maintenance and management.

Conclusions: Caregiver confidence may play a role in CC to self-care. Interventions to improve CC to HF self-care should not only be focused on improving caregiver preparedness but also should consider the role of caregiver confidence.

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Series: Journal of cardiovascular nursing
ISSN: 0889-4655
ISSN-E: 1550-5049
ISSN-L: 0889-4655
Volume: 35
Issue: 3
Pages: 243 - 252
DOI: 10.1097/JCN.0000000000000632
Type of Publication: A1 Journal article – refereed
Field of Science: 316 Nursing
Funding: This study was funded by the Center of Excellence for Nursing Scholarship, Rome.
Copyright information: Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. This is a non-final version of an article published in final form in The Journal of Cardiovascular Nursing: 5/6 2020 - Volume 35 - Issue 3 - p 243-252 doi: 10.1097/JCN.0000000000000632