Heterogeneous Dyadic Quality of Life Profiles in Heart Failure Patient‒Caregiver Dyads: A Latent Profile Analysis

Wenhai Fan,1,2 Xiaoqing Zhang,3 Chunxia Li,3 Lihong Li,1 Lijun Wang,1 Mingming Yu21Department of Nursing, Civil Aviation General Hospital, Peking University, Beijing, People’s Republic of China; 2School of Nursing, Peking University, Beijing, People’s Republic of China; 3Department of Cardiology, Civil Aviation General Hospital, Peking University, Beijing, People’s Republic of ChinaCorrespondence: Mingming Yu, School of Nursing, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing, 100191, People’s Republic of China, Tel +8618201008218, Email [email protected]: Heart failure affects both patients and their caregivers, yet patterns of quality of life (QoL) alignment or mismatch within patient–caregiver dyads remain insufficiently understood.Objective: To identify heterogeneity of dyadic QoL profiles in heart failure patient‒caregiver dyads through latent profile analysis and to examine factors associated with profile membership.Methods: This was a secondary analysis of a cross-sectional study including 201 heart failure patient–caregiver dyads from four tertiary hospitals in Beijing, China, between September 2023 and August 2024. QoL, symptom burden, caregiver burden, dyadic relationship quality, and family functioning were assessed. Latent profile analysis was performed using Mplus 8.3 and multinomial logistic regression was used to identify factors associated with profile membership.Results: Three profiles were identified: (1) the low dyadic QoL profile (39.8%), with poor QoL in both members; (2) the incongruent dyadic QoL profile (27.4%), characterized by lower patient QoL and relatively higher caregiver QoL; and (3) the high dyadic QoL profile (32.8%) in both members. With the high dyadic QoL profile as the reference category, greater caregiver burden (OR=1.32, 95% CI=1.14‒1.53) and poorer caregiver-reported relationship quality (OR=1.15, 95% CI=1.01‒1.30) were associated with greater odds of membership in the low dyadic QoL profile. Higher patient symptom burden was associated with greater odds of the low and incongruent profiles than the high profile (both OR=1.04, 95% CI=1.02‒1.06). Dyads with non-spousal caregivers had higher odds of membership in the incongruent profile than in the high dyadic QoL profile (OR=11.49, 95% CI=1.78‒74.23).Conclusion: Three distinct dyadic QoL profiles were identified among heart failure patient‒caregiver dyads. Patient symptom burden, caregiver burden, and relationship quality were associated with profile membership. These findings may inform tailored dyadic interventions, particularly for dyads with low or incongruent dyadic QoL. Longitudinal and interventional studies are needed to evaluate these implications.Keywords: dyadic quality of life, heart failure, latent profile analysis, burden, relationship quality, family functioning