Canadian Heart Failure Patient and Caregiver Emotions

Abstract:

Mounting evidence suggests that caring for someone with heart failure (HF) imposes significant physical and emotional demands on primary caregivers (CGs). Symptoms of depression have been described by CGs; however, studies examining HF patient variables that contribute to CG depression have yielded mixed results Furthermore, the majority of these studies have measured HF severity and patient demographic variables while, to our knowledge, only three studies have measured depressive symptoms in HF patients. The purpose of this multi-site study was to determine independent predictors of symptoms of depression in CGs from variables related to both HF patient disease severity and symptoms of depression. Using a prospective, cross-sectional design, primary CGs accompanying a HF patient to a clinic appointment were recruited from 3 sites within the Canadian Heart Failure Network. Patients
and CGs completed the Hospital Anxiety and Depression Scale (HADS) and CGs also completed the Dutch Objective Burden Inventory (DOBI). Results: Caregivers (n548) were mainly spouses of the HF patient (77%) with a mean age of 62 (SD12) years. Patients (n548) were older (mean age 69 years (SD 12), 71% were male, and 54% had NYHA III-IV HF symptoms. The final regression model was statistically significant and accounted for 33 % of the total variance in CG depression (p5.006). Using stepwise linear regression, the only significant predictor was patient depression (=0.439, p=0.006). In univariate analysis, patient HF severity was significantly associated with CG depression; however, this variable lost significance in
the multivariate analysis when patient depression was entered into the model. Thus, HF patients’ symptoms of depression, not HF disease severity, predicted CG symptoms of depression. These findings suggest that comprehensive care of HF patients should include consideration of depression in both HF patients and their CGs. Furthermore, future studies exploring CG depression need to extend beyond the traditionally employed HF patient variables and include patient symptoms of depression. Such key information can then guide intervention studies striving to alleviate symptoms of depression when caring for someone with HF.