Acceptability and Usefulness of a Dyadic Problem-Solving Partnership to Promote Rural Heart Failure Self-care

Heart failure (HF) is a common chronic illness in the United States, and rural individuals have a higher risk of this disease, often with negative health outcomes. While dyads cope more effectively in working together to address heart-related problems, there are few innovative studies exploring the acceptability and usefulness of self-care partnership programs to assist rural dyads in managing symptoms and daily challenges.

We examined the acceptability and usefulness of a telephone problem-solving program with HF dyads for managing HF-related problems in the home. Self-care areas, process outcomes, and underlying structures and patterns regarding acceptability and usefulness were addressed.

Data for this qualitative descriptive study were collected via individual telephone interviews with 29 HF dyads, using an investigator-developed semi-structured interview guide. This analysis focused on the midpoint, in-depth, 5-week analysis of the 12-week parent study to compare early and later data regarding acceptability and usefulness. Adjusted matrix analyses and multiple correspondence analysis were used to address the study aims.

Most dyads were completely supportive of the program, and 12 suggested strategies for improving its usefulness. Most dyads focused on self-care maintenance (diet, exercise) problems and self-monitoring (abnormal signs and symptoms). A gender pattern difference was identified in addressing self-care maintenance problems.

Our study fills an important gap regarding collaborative transition and empowerment of self-care in rural HF dyads. It also highlights the need for longitudinal research on how gender pattern differences influence self-care in rural dyads.