Co-occurring self-efficacy, anxiety, and depression in caregivers of patients with heart failure: A Group-Based Dual-Trajectory Modeling Approach

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Abstract

Background

Self-efficacy and mental health present mutually influencing relationships in caregivers of patients with heart failure (HF). There is currently a lack of understanding the synergistic developmental mechanisms of self-efficacy, anxiety, and depression in caregivers. The purpose of the study was to examine the individual and dual trajectories of caregiver self-efficacy, anxiety, and depression during the first three months after the discharge of patients with HF.

Methods

A prospective cohort study was conducted from June 2022 to May 2024, in four tertiary hospitals in Tianjin, China. A total of 299 family caregivers of patients with HF were enrolled in the cohort, and 267 completed follow-ups. Group-based dual trajectory modeling was employed to examine the development of self-efficacy, anxiety, and depression.

Results

The mean (SD) age of caregivers was 58.3 (13.1) years, and 164 (61.4%) were women. Three trajectories of caregiver self-efficacy were identified: low-curve (25.1%), middle-curve (67.8%), and high-stable (7.1%). Regular exercise, work status, and chronic disease were associated with the different caregiver self-efficacy trajectories. A 3-class trajectory solution was chosen for depression and anxiety when analyzed separately. The proportions of ideal combinations of high-stable self-efficacy and initial-to-mild anxiety or depression were extremely small, at 12.60% and 8.00%, respectively. Caregivers had limited and inconsistent abilities to regulate the effects of anxiety and depression on their self-efficacy.

Conclusion

The present study identified three distinct trajectories of self-efficacy, anxiety, and depression among family caregivers of patients with HF. The dual-trajectory models revealed the probability of interrelationships between caregiver self-efficacy trajectories and those of anxiety and depression, suggesting substantial opportunities to enhance caregivers’ self-efficacy and mental well-being of patients with HF.

Supplementary information

The online version contains supplementary material available at 10.1186/s12912-025-02995-0.

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Author and article information

Contributors

Xiaoying Zang: xiaoyingzang@163.com

Xiaonan Zhang: zhangxiaonan19@163.com

Journal

Journal ID (nlm-ta): BMC Nurs

Journal ID (iso-abbrev): BMC Nurs

Title: BMC Nursing

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6955

Publication date (Electronic): 31 March 2025

Publication date PMC-release: 31 March 2025

Publication date Collection: 2025

Volume: 24

Electronic Location Identifier: 351

Affiliations

[1 ]School of Nursing, Tianjin Medical University, ( https://ror.org/02mh8wx89) No. 22 Qixiangtai Road, Heping District, Tianjin, 300070 China

[2 ]Department of Nursing, The Second Hospital of Tianjin Medical University, ( https://ror.org/03rc99w60) Tianjin, China

[3 ]Department of Nursing, Tianjin Medical University General Hospital, ( https://ror.org/003sav965) Tianjin, China

[4 ]Department of Cardiology, The Second Hospital of Tianjin Medical University, ( https://ror.org/03rc99w60) Tianjin, China

Article

Publisher ID: 2995

DOI: 10.1186/s12912-025-02995-0

PMC ID: 11959719

PubMed ID: 40165181

SO-VID: 380b34ad-1467-4ae6-9f9d-5e740f5b672a

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 22 July 2024

Date accepted : 17 March 2025

Custom metadata

ScienceOpen disciplines: Nursing

Keywords: heart failure,caregivers,self-efficacy,depression,anxiety

Data availability: