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Author Notes:

Corresponding author: Kelly Stamp, PhD, ANP-C, RN Assistant Professor 140 Commonwealth Avenue Boston College, School of Nursing Cushing Hall 307 Chestnut Hill, MA 02467 (617) 552-2119 stampk@bc.edu

We acknowledge Judy Robinson, RN, MSN, Kendaly Meadows, RN, MA, Bridget Fielder, RN, MSN and Christina Quinn, RN, PhD for their outstanding contributions to this project.

There are no disclosures or conflicts of interests.

Subjects:

Research Funding:

This study was supported by (1) A Family Partnership Intervention for Heart Failure”, (RO1 R08800) National Institute of Nursing Research, NIH 07/01/04-11/30/09, PI: S. Dunbar and in part by PHS Grant M01 RR0039 from the General Clinical Research Center program, National Institutes of Health, National Center for Research Resources and PHS Grant UL1 RR025008 from the Clinical and Translational Science Award program, National Institutes of Health, National Center for Research Resources, and the Atlanta Veterans Administration Medical Center.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Nursing
  • Cardiovascular System & Cardiology
  • depressive symptoms
  • family context
  • heart failure
  • quality of life
  • SUPPORTING AUTONOMY
  • AFRICAN-AMERICAN
  • SELF-CARE
  • INTERVENTION
  • PATTERNS
  • MODEL
  • TRIAL

Family Context Influences Psychological Outcomes of Depressive Symptoms and Emotional Quality of Life in Patients With Heart Failure

Tools:

Journal Title:

Journal of Cardiovascular Nursing

Volume:

Volume 29, Number 6

Publisher:

, Pages 517-527

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background: Although family influences in heart failure (HF) care are considered important, little evidence is available regarding relationships between the family context and specific outcomes for patients with HF. Objective: The aim of this study was to examine the relationships of patient perceptions of family functioning, autonomy support, and perceived criticism, as well as their family member's (FM) HF knowledge, with patient outcomes of depressive symptoms and HF quality of life (QOL). Methods: Participants (n = 117) with HF were enrolled in a family partnership intervention study. Self-report questionnaires measuring the HF patient's perceptions of family context and the FM's knowledge were analyzed relative to the HF patient's outcomes using correlations and sequential multivariate regression analyses. Only preintervention, baseline data are reported here. Results: Age, ethnicity, Charlson comorbidity index, global family functioning, and FM's HF knowledge accounted for 37.8% (P < .001) of the variance in the patient's depressive symptoms. An additional moderating effect of ethnicity on the association between global family functioning and patient's depressive symptoms was significant (change R 2 = 0.06, P = .001), resulting in a final model that accounted for 43.3% of depressive symptom variance. Age, ethnicity, global family functioning, and autonomy support accounted for 24.9% (P < .001) of the variance in emotional HF QOL. An additional moderating effect of ethnicity on the association between global family functioning and patient's emotional HF QOL was significant (change R 2 = 0.05, P = .009), resulting in a final model that accounted for 28.9% of emotional QOL variance. Conclusions: This study underscores the importance of the patient's perspective on family functioning and autonomy support, along with FM's HF knowledge, on HF patient outcomes moderated by ethnicity. Future interventions could target the modifiable patient-family context relationships for improving depressive symptoms and QOL in HF patients. These findings point to the need for greater family assessment to identify those at risk for worse outcomes and to guide family focused interventions.

Copyright information:

Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.

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