Abstract 4141366: Teamwork Makes the Dream Work: Self-care and Depressive Symptoms in Rural Heart Failure Dyads

Introduction: Managing heart failure (HF) in the home is stressful and complex for rural dyads who experience unique challenges and barriers to optimal HF self-care (SC). Innovative, tailored, dyadic problem-solving interventions are needed which support teamwork in managing HF SC problems in the home to enhance dyadic HF SC and reduce depressive symptoms. Research Question: Will participation in a 3-month dyadic, telephone-based problem-solving intervention focused on dyadic HF SC problems experienced in the home improve patient and care partner-contributed HF SC and reduce depressive symptoms in rural dyads living with HF? Methods: Using a dyadic single-group repeated-measures design, 41 rural dyads (patient-informal care partner) living with HF participated in 8 telephone sessions with a registered nurse to identify and develop management strategies for dyadic HF SC problems experienced in the home. Data were collected at baseline and 5-, 9-, and 13-weeks post baseline using the Self-care of HF Index (SCHFI), Caregiver Contribution to the SCHFI, and the Center for Epidemiological Studies – Depression Scale. HF patients were mostly female (59%), married (66.7%) Caucasians (69.2%), with 2-3 comorbidities (53.8%) and Class 2 NYHA HF (69.2%). Care partners were primarily female (58.5%), married (75.6%) Caucasians (70.7%), and spouses of the HF patient (68.3%), with 0-1 comorbidities (58.6%), and had been providing care for ≥ 5 years (46.3%). Descriptive statistics were used to examine dyad characteristics and outcome variables at each time point. Changes in patients' and care partners’ outcomes were analyzed using dyadic Growth Curve Modeling within the Multilevel Modeling framework. Results: Across time, patient scores improved for depressive symptoms ( b = -1.81, p = .002) and SC maintenance ( b = 2.29, p < .001). SC confidence increased in both patients ( b = 2.51, p < .001) and care partners ( b = 2.26, p = .01). Increases in patient SC management across time was noted but non-significant ( b = 1.46, p = .133 for patients; b = 0.60, p = .561 for care partners). Conclusions: Problem-solving interventions in rural dyads living with HF may be helpful in addressing HF SC issues and depressive symptoms in the home, especially in HF patients. However, more research is needed to examine this promising intervention in a larger clinical trial.