Profiles of Dyadic Self-care Congruence and Patient Symptom Burden in Heart Failure

Background: Patients with heart failure (HF) experience several symptoms that can be alleviated by self-care, to which caregivers can contribute too. The degree of congruence between patients' and caregivers' perceptions of chronic illness should be explored to gain a holistic understanding of the dyadic illness management. Objective: The aim of this study was to explore dyads in HF based on the congruence between patient self-care and caregiver contribution to patient self-care, and the levels of physical symptom burden in each dyad type. Methods: This is a secondary analysis of data from the MOTIVATE-HF randomized controlled trial, which enrolled 510 dyads of patients with HF and their caregivers. Latent class mixture modeling was used to identify distinct patterns among empirical Bayes estimates of within-dyad congruence in self-care maintenance, management, and confidence, as well as symptom burden score. χ2 Tests and analysis of variance were used to compare characteristics among the identified classes. Results: We identified 3 classes of dyads. In class 1 (17%), caregivers contributed more to HF care than patients; patients in this class reported the highest symptom burden. In class 2 (7%), patients performed more self-care than caregivers contributed to HF care; patients in this class reported the lowest symptom burden. In class 3 (76%), patients and caregivers contributed similarly to HF care. Conclusions: In HF, different dyad types exist based on the congruence between patient self-care and caregiver contribution to self-care, and the levels of patient symptom burden. This is pivotal to help generate an evidence base for symptom management interventions.