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"Teamwork Makes the Dream Work": Initial Evidence for Enhancing Problem-Solving in Rural Heart Failure Dyads
Lucinda J Graven1, Thomas Ledermann2, Erin Stearns3
1Lucinda J. Graven, PhD, APRN, FAHA, FAAN, Associate Professor, College of Nursing, Florida State University, Tallahassee.
Background:
Managing heart failure (HF) is stressful for rural dyads who experience unique challenges to optimal HF self-care and a higher emotional burden. Tailored, dyadic problem-solving interventions that support teamwork in managing HF problems may enhance dyadic HF self-care and reduce depressive symptoms.
Objective:
To examine the feasibility and preliminary effects of a telephone-based, tailored, dyadic problem-solving intervention on problem-solving, patient and care partner contributions to HF self-care, and depressive symptoms.
Methods:
Using a dyadic single-group repeated-measures design, 41 rural HF dyads participated in 8 telephone sessions to address dyadic HF-related problems. Data on problem-solving, HF self-care, and depressive symptoms were collected at baseline and at 5, 9, and 13 weeks. Descriptive statistics were employed to analyze demographics and outcome variables. Changes in patient and care partner outcomes were analyzed using dyadic growth curve modeling.
Results:
Patients were on average 66.54 years old, mostly White (69.2%), married (66.7%), and female (59%). Care partners were on average 60.83 years old, mostly White (70.7%), married (75.6%), females (58.5%), and spouses (68.3%). Patient scores significantly improved for problem-solving ( b = 0.45, P < .001), self-care maintenance ( b = 2.29, P < .001), and depressive symptoms ( b = -1.81, P = .002). Self-care confidence significantly increased in both patients ( b = 2.51, P < .001) and care partners ( b = 2.26, P = .01).
Conclusions:
Dyadic problem-solving interventions seem to be beneficial in improving problem-solving, HF self-care, and depressive symptoms, especially in rural patients. More research is needed to examine this intervention in a larger clinical trial.
Clinical Trials Registration:
This study is registered at clinicaltrials.gov (#00001621).
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