PMID- 28513209
OWN - NLM
STAT- MEDLINE
DCOM- 20190528
LR  - 20190528
IS  - 1873-1953 (Electronic)
IS  - 1474-5151 (Print)
IS  - 1474-5151 (Linking)
VI  - 16
IP  - 8
DP  - 2017 Dec
TI  - Caregiver determinants of patient clinical event risk in heart failure.
PG  - 707-714
LID - 10.1177/1474515117711305 [doi]
AB  - BACKGROUND: Preventing hospitalization and improving event-free survival are 
      primary goals of heart failure (HF) treatment according to current European 
      Society of Cardiology guidelines; however, substantial uncertainty remains in our 
      ability to predict risk and improve outcomes. Although caregivers often assist 
      patients to manage their HF, little is known about their influence on clinical 
      outcomes. AIMS: To quantify the influence of patient and caregiver 
      characteristics on patient clinical event risk in HF. METHODS: This was a 
      secondary analysis of data using a sample of Italian adults with HF and their 
      informal caregivers ( n = 183 patient-caregiver dyads). HF patients were followed 
      over 12 months for the following clinical events: hospitalization for HF, 
      emergency room visit for HF or all-cause mortality. Influence of baseline 
      caregiver- and patient-level factors (patient and caregiver age; dyad 
      relationship type; patient New York Heart Association (NYHA) Class, cognition, 
      and comorbidities; and caregiver strain, mental health status, and contributions 
      to HF self-care) on patient risk of death or hospitalization/emergency room use 
      was quantified using Cox proportional hazards regression. RESULTS: Over the 
      course of follow up, 32.8% of patients died, 19.7% were hospitalized for HF and 
      10.4% visited the emergency room. Higher caregiver strain, better caregiver 
      mental health status and greater caregiver contributions to HF self-care 
      maintenance were associated with significantly better event-free survival. Worse 
      patient functional class and greater caregiver contributions to patient self-care 
      management were associated with significantly worse patient event-free survival. 
      CONCLUSION: Considering caregiving factors together with patient factors 
      significantly increases our understanding of patient clinical event risk in HF.
FAU - Bidwell, Julie T
AU  - Bidwell JT
AD  - 1 Oregon Health & Science University School of Nursing, Portland, OR, USA.
AD  - a Present institution/address: Emory University Nell Hodgson Woodruff School of 
      Nursing, Atlanta, GA, USA.
FAU - Vellone, Ercole
AU  - Vellone E
AD  - 2 University of Rome, Tor Vergata, Rome, Italy.
FAU - Lyons, Karen S
AU  - Lyons KS
AD  - 1 Oregon Health & Science University School of Nursing, Portland, OR, USA.
FAU - D'Agostino, Fabio
AU  - D'Agostino F
AD  - 2 University of Rome, Tor Vergata, Rome, Italy.
FAU - Riegel, Barbara
AU  - Riegel B
AD  - 3 University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
FAU - Paturzo, Marco
AU  - Paturzo M
AD  - 2 University of Rome, Tor Vergata, Rome, Italy.
FAU - Hiatt, Shirin O
AU  - Hiatt SO
AD  - 1 Oregon Health & Science University School of Nursing, Portland, OR, USA.
FAU - Alvaro, Rosaria
AU  - Alvaro R
AD  - 2 University of Rome, Tor Vergata, Rome, Italy.
FAU - Lee, Christopher S
AU  - Lee CS
AD  - 1 Oregon Health & Science University School of Nursing, Portland, OR, USA.
AD  - 4 Oregon Health & Science University Knight Cardiovascular Institute, Portland, 
      OR, USA.
LA  - eng
GR  - F31 NR014760/NR/NINR NIH HHS/United States
GR  - T32 NR012715/NR/NINR NIH HHS/United States
PT  - Journal Article
DEP - 20170517
PL  - England
TA  - Eur J Cardiovasc Nurs
JT  - European journal of cardiovascular nursing
JID - 101128793
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Caregivers/*psychology/*statistics & numerical data
MH  - Female
MH  - Heart Failure/epidemiology/mortality/*psychology
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Italy/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Risk Assessment/*statistics & numerical data
MH  - Self Care/*psychology/*statistics & numerical data
PMC - PMC5665710
MID - NIHMS895353
OTO - NOTNLM
OT  - Heart failure
OT  - caregivers
OT  - hospitalization
OT  - mortality
COIS- Declaration of Conflicting Interests: The authors declare that there is no 
      conflict of interest
EDAT- 2017/05/18 06:00
MHDA- 2019/05/29 06:00
PMCR- 2018/12/01
CRDT- 2017/05/18 06:00
PHST- 2017/05/18 06:00 [pubmed]
PHST- 2019/05/29 06:00 [medline]
PHST- 2017/05/18 06:00 [entrez]
PHST- 2018/12/01 00:00 [pmc-release]
AID - 10.1177/1474515117711305 [doi]
PST - ppublish
SO  - Eur J Cardiovasc Nurs. 2017 Dec;16(8):707-714. doi: 10.1177/1474515117711305. 
      Epub 2017 May 17.