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      Relationship and Communication Characteristics Associated with Agreement between Heart Failure Patients and Their CarePartners on Patient Depressive Symptoms

      research-article
      , MPH, PhD 1 , * , , PhD 2 , , PhD 3 , 4 , , PhD, MA, MS 5 , 6
      Aging & mental health
      caregivers, heart failure, depression, communication, proxy

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          Abstract

          Objectives:

          Informal caregivers who recognize patients’ depressive symptoms can better support self-care and encourage patients to seek treatment. We examined patient-caregiver agreement among patients with heart failure (HF). Our objectives were to (1) identify distinct groups of HF patients and their out-of-home informal caregivers (CarePartners) based on their relationship and communication characteristics, and (2) compare how these groups agree on the patients’ depressive symptoms.

          Method:

          We used baseline data from a comparative effectiveness trial of a self-care support program for veterans with HF treated in outpatient clinics from 2009–2012. We used a cross-sectional design and latent class analysis (LCA) approach to identify distinct groups of patient-CarePartner dyads (n=201) based on relationship and communication characteristics then evaluated agreement on patients’ depressive symptoms within these groups.

          Results:

          The LCA analysis identified four groups: Collaborative (n=102 dyads, 51%), Avoidant (n=33 dyads, 16%), Distant (n=35 dyads, 17%), and Antagonistic (n=31 dyads, 15%). Dyadic agreement on the patients’ depressive symptoms was highest in the Distant (Kappa (κ)=0.44, r=0.39) and Collaborative groups (κ=0.19, r=0.32), and relatively poor in the Avoidant (κ= –0.20, r=0.17) and Antagonistic (κ=–0.01, r=0.004) groups. Patients in Avoidant (61%) and Antagonistic groups (74%) more frequently had depression based on self-report than patients in Collaborative (46%) and Distant (34%) groups.

          Conclusion:

          Caregiver relationships in HF tend to be either Collaborative, Avoidant, Distant, or Antagonistic. Patients’ depressive symptoms may negatively affect how they communicate with their caregivers. At the same time, improved patient-caregiver communication could enhance dyadic consensus about the patient’s depressive symptoms.

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          Author and article information

          Journal
          9705773
          25460
          Aging Ment Health
          Aging Ment Health
          Aging & mental health
          1360-7863
          1364-6915
          21 November 2018
          20 December 2018
          September 2019
          01 September 2020
          : 23
          : 9
          : 1122-1129
          Affiliations
          [1 ]Department of Health and Exercise Science, Appalachian State University, Boone, NC
          [2 ]Department of Family Medicine, University of Michigan, Ann Arbor, MI
          [3 ]Center for Clinical Management Research, Ann Arbor Department of Veterans Affairs, Ann Arbor, MI
          [4 ]Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI
          [5 ]Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, CA
          [6 ]Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
          Author notes
          [* ]Corresponding author: Erin Bouldin, MPH, PhD, Department of Health and Exercise Science, Beaver College of Health Sciences, Appalachian State University, 111 Rivers Street, ASU Box 32071, Boone, NC 28608-2071, Phone: 828-262-6892, Fax: 828-262-3138, BouldinEL@ 123456appstate.edu
          Article
          PMC6586543 PMC6586543 6586543 nihpa1512329
          10.1080/13607863.2018.1481923
          6586543
          30569750
          f27a34f2-6bae-4e87-afed-aec455926251
          History
          Categories
          Article

          heart failure,proxy,caregivers,communication,depression
          heart failure, proxy, caregivers, communication, depression

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