Physical and Psychosocial Characteristics of Family Givers of Persons with Heart Failure

Wednesday, 24 July 2013: 9:10 AM

Rebecca A. Gary, RN, PhD, FAAN, FAHA1
Sandra B. Dunbar, RN, DSN, FAAN2
Susan Bauer-Wu, PhD, RN2
Kenneth W. Hepburn, PhD3
Melinda Higgins, PhD2
Elizabeth Corwin, RN, PhD, FNP2
(1)Nell Hodgson Woodruff School of Nursing, Emory University, Altanta, GA
(2)Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA
(3)Nell Hodgson Woodruff School of Nursing, Emory Univeristy, Atlanta, GA

Learning Objective 1: Describe common physical function and psychological characteristics of family caregivers.

Learning Objective 2: Identify methos to improve physical and psychological functioning in family caregivers.

Purpose: Family caregivers (FCGs) of persons with heart failure (HF) are at high risk for poor physical and psychological function due to stress and limited time for participation in routine physical activity.  The purpose of this descriptive study was to identify physical and psychological factors that heighten risk for poor health outcomes in this FCG population.

Methods: FCGs of persons with HF who completed baseline evaluation for an intervention study were included in data analysis.  Psychological outcomes included perceived stress (Perceived Stress Scale [PSS]) and depressive symptoms (Patient Health Questionnaire 9 [PHQ 9]). The Community Healthy Activities Model Program for Seniors [CHAMPS]), peak oxygen consumption (V02) and the six minute walk test [6MWT] were included as physical function outcomes.  

Results: Participants (n=90) with a mean age of 55 ± 11.5 who were predominately female (92%), Black (53%), overweight/obese with a mean body mass index (BMI) of 31 ± 7 participated.  The mean PSS score of 29 ± 4 (range, 21-38), indicating many FCGs perceived their stress level to be severe. Approximately one-fifth (n=19, 21%) were experiencing depressive symptoms.   Considerable variability was present in the physical function measures. CHAMPS  mean kilocalories expended per week in moderate levels in physical activity were 1785 ± 648 (range, 0 - 25307).  The mean V02 of 30 ± 1 (range, 18-32) was normal for cardiorespiratory fitness in predominately female participants; 6MWT distance was 1239 ± 228 feet (range, 530 – 1890), indicating some participants had substantial physical limitation.

 Conclusion: The findings support that FCGs perceive very high levels of stress and experience depressive symptoms that are 2-3 times greater than in the general population, placing them at risk for poor health outcomes. Some FCGs also have considerable physical function impairment that may also contribute to additional health risks.  Future interventions should address psychological and physical outcomes to optimize FCG health.