Abstract 18108: Effects of a Heart Failure Family Caregiver Intervention on Caregiver Strain and Outcomes
Background and Purpose: Family Caregivers (FCGs) of persons with heart failure (HF) report social, emotional and physical concerns and life changes due to caregiving. Few interventions have addressed the needs of FCGs. This study designed and tested psychoeducational (PsychEd) and psychoeducational plus exercise (PsychEd+EX) interventions against a usual care attention control (UCAC) group for effects on perceived HF FCG caregiver strain (CS) and life changes specifically resulting from providing care.
Methods: FCGs of persons with HF (N=127, mean age 55.3 ± 11.5 years, 92% women, 58% African American) were randomized to one of the three groups with data collected at baseline prior to randomization and at 6 months. Both PsychEd and PsychEd+Ex groups attended four weekly sessions focused on HF caregiving and FCG needs, coping, problem-solving, resources, and social support. PsychEd+Ex also received exercise counseling and support through scripted monthly phone calls. UCAC attended one group focused on healthy lifestyles. Variables and measures were depressive symptoms (PHQ-9), Caregiver Strain (mental and physical CS) and life change from caregiving (Bakas Caregiving Outcome Scale; BCOS).The effects for group, time and group X time (GxT) interactions were analyzed using RM-ANOVA and generalized estimating equations (GEE) with apriori defined post hoc comparisons.
Results: Groups did not differ at baseline; 53.2% had depressive symptoms. For BCOS scores, RM-ANOVA revealed significant GxT interaction (p=.008); both PsychED (p=.001) and PsychED+Ex (p=<.001) demonstrated increased positive life change between baseline and 6M over UCAC. The proportion of FCGs reporting the highest category of CS was reduced in the PsychEd+EX group for both mental (31.2 to 12.1%, p=.01) and physical strain (16.7 to 6.1%, p=.03), whereas PsychEd reported reduced physical strain (9.1 to 2.7%, p=.04).
Conclusions: HF FCG outcomes can be improved though interventions focused on improving coping and addressing psychosocial and physical needs of FCGs. Combined group interventions, telephone counseling, and exercise were effective over usual care to reduce both mental and physical strain and to improve perceived positive life changes from HF caregiving.
Author Disclosures: S.B. Dunbar: Research Grant; Modest; NIH. Research Grant; Significant; significant. R.A. Gary: Research Grant; Significant; NIH. E. Corwin: Research Grant; Significant; NIH. A. Miller: Research Grant; Significant; NIH. M.K. Higgins: Research Grant; Significant; NIH. J. Butler: Research Grant; Significant; NIH.
- © 2014 by American Heart Association, Inc.