Patient and caregiver predictors of caregiver burden: a longitudinal analysis

Purpose: To assess differences in self-care and quality of life between patients with heart failure and their family caregivers at baseline and 6 months; to explore whether patients' and family caregivers' personal characteristics and self-care at baseline predict caregiver burden at 6 months. Method: A longitudinal study was conducted with 46 patient-caregiver dyads (80.4% male patients, 80.4% female caregivers). Patients completed the Self-Care of Heart Failure Index and caregivers completed the Caregiver Contribution to Self-Care of Heart Failure Index. Both groups completed the SF-12 Health Survey and the Minnesota Living with Heart Failure Questionnaire. Caregivers also completed the Zarit Burden Caregiver Scale at both time-points. Multiple linear regression was used to identify baseline predictors of caregiver burden (outcome) at 6 months. Results: Patients and caregivers significantly differed in self-care maintenance at baseline (P=0.015) but not at 6 months. Patients had poorer physical health (SF-12 Physical Component Score) and worse Minnesota Living with Heart Failure Questionnaire scores (total score, Physical Component Score and Emotional Component Score) than their caregivers at both time points. Patient engagement in self-care and Caregiver Contribution to Self-Care of Heart Failure Index did not predict caregiver burden at 6 months' follow-up. Patients' physical inactivity, caregivers' emotional health and baseline burden predicted burden at 6 months. Conclusions: Caregiver burden persisted over time. Patients' physical activity is crucial in predicting caregiver burden, along with caregivers' emotional health and baseline burden. Healthcare teams should encourage patients with heart failure to engage in cardiac rehabilitation, where possible, to mitigate the hazards associated with immobility. Similarly, at-risk caregivers should be identified early and the necessary supported offered.