Keywords

quality of life, self-care, symptom burden

 

Authors

  1. McMillan, Susan C. PhD, ARNP, FAAN
  2. Small, Brent J. PhD
  3. Haley, William E. PhD
  4. Zambroski, Cheryl PhD, RN
  5. Buck, Harleah G. PhD, RN

Abstract

The purpose of this 2-group comparative experimental study was to pilot test the heart failure-COPE (creativity, optimism, planning, and expert information) intervention for caregivers of heart failure patients in hospice care in a small randomized trial focusing on caregiver burden, quality of life, depression and anxiety, caregiver knowledge, patient quality of life, and emergency room visits and hospitalizations. Forty patient-caregiver dyads participated with the treatment group receiving the COPE-heart failure intervention in 21 days, and both groups provided data at baseline and at weeks 4 and 5. Results showed no effect of the intervention, but the sample was small, and patients had been diagnosed for a mean of more than 10 years. The most commonly reported symptoms by patients were dry mouth and fatigue. Self-care was less than adequate, but depression and distress among patients were low, whereas quality-of-life scores were relatively high. Caregivers reported low distress from patient symptoms and from caregiving burden and low mean anxiety and depression scores. We concluded that caregivers had been managing heart failure symptoms for a long time and that our intervention near the end of the disease trajectory was not needed; caregivers already felt competent to manage the care of these patients.