Caregiving tasks and caregiver burden; effects of an psycho-educational intervention in partners of patients with post-operative heart failure

  • Susanna Ågren
    Department of Medical and Health Sciences, Linköping University, Department of Cardiothoracic Surgery, Linköping, Sweden

    Department of Medical and Health Sciences, Linköping University, Division of Nursing Sciences, Department of Cardiology, Linköping University, Linköping, Sweden
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  • Anna Strömberg
    Department of Medical and Health Sciences, Linköping University, Division of Nursing Sciences, Department of Cardiology, Linköping University, Linköping, Sweden
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  • Tiny Jaarsma
    Department of Social and Welfare Studies, Linköping University, Linköping, Sweden
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  • Marie Louise A. Luttik
    Corresponding author. Department of Medical and Health Sciences, Division of Nursing Sciences, Department of Cardiology, Linköping University, Linköping, Sweden. Tel.: +46 31 50 3610321.
    Department of Medical and Health Sciences, Linköping University, Division of Nursing Sciences, Department of Cardiology, Linköping University, Linköping, Sweden

    Research Group Nursing Diagnostics, Hanze University of Applied Sciences, Groningen, the Netherlands
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      To evaluate the effects of a psycho-educational intervention on caregiver burden in partners of patients with postoperative heart failure.


      Since partners of cardiac surgery patients play a significant role in the patient’s recovery, it is important to address their needs during hospitalization and after discharge.


      Forty-two patients with postoperative heart failure and their partners participated in a randomized controlled pilot study. Dyads in the intervention group received psycho-educational support from a multidisciplinary team. Dyads in the control group received usual care.


      No significant differences were found in the performance of caregiving tasks and perceived caregiver burden in the control versus the intervention group.


      A pilot study exploring the effects of a psycho-educational intervention in patients and their partners did not reveal significant effects with regard to reduced feelings of burden in partners. Alleviating caregiver burden in partners may need a more intense or specific approach.


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        • Van Horn E.
        • Tesh A.
        The effect of critical care hospitalization on family members: stress and responses.
        Dimens Crit Care Nurs. 2000; 19: 40-49
        • Van Horn E.R.
        • Kautz D.
        Promotion of family integrity in the acute care setting: a review of the literature.
        Dimens Crit Care Nurs. 2007; 26 (quiz 8–9): 101-117
        • Agren S.
        • Evangelista L.
        • Davidson T.
        • Strömberg A.
        The influence of chronic heart failure in patient-partner dyads-a comparative study addressing issues of health-related quality of life.
        J Cardiovasc Nurs. 2011; 26: 65-73
        • Rantanen A.
        • Tarkka M.T.
        • Kaunonen M.
        • et al.
        Health-related quality of life after coronary artery bypass grafting.
        J Adv Nurs. 2009; 65: 1926-1936
        • Tully P.J.
        • Baker R.A.
        • Turnbull D.
        • Winefield H.
        The role of depression and anxiety symptoms in hospital readmissions after cardiac surgery.
        J Behav Med. 2008; 31: 281-290
        • Agren S.
        • Frisman G.
        • Berg S.
        • Svedjeholm R.
        • Stromberg A.
        Addressing spouses' unique needs after cardiac surgery when recovery is complicated by heart failure.
        Heart Lung. 2009; 38 (Epub 2009 Jan 24): 284-291
        • McMurray J.J.
        • Adamopoulos S.
        • Anker S.D.
        • et al.
        ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC.
        Eur J Heart Fail. 2012; 14: 803-869
        • Vanky F.B.
        • Hakanson E.
        • Svedjeholm R.
        Long-term consequences of postoperative heart failure after surgery for aortic stenosis compared with coronary surgery.
        Ann Thorac Surg. 2007; 83: 2036-2043
        • Vanky F.B.
        • Hakanson E.
        • Tamas E.
        • Svedjeholm R.
        Risk factors for postoperative heart failure in patients operated on for aortic stenosis.
        Ann Thorac Surg. 2006; 81: 1297-1304
        • Holm J.
        • Håkanson R.E.
        • Vanky F.
        • Svedjeholm R.
        Mixed venous oxygen saturation is a prognostic marker after surgery for aortic stenosis.
        Acta Anaesthesiol Scand. 2010; 54 (Epub 2011 Jun 16): 589-595
        • Chung M.L.
        • Moser D.K.
        • Lennie T.A.
        • Frasier S.K.
        Perceived social support predicted quality of life in patients with heart failure, but the effect is mediated by depressive symptoms.
        Qual Life Res. 2013; 22 (Epub 2012 Oct 18): 1555-1563
        • Årestedt K.
        • Saveman B.I.
        • Johansson P.
        • Blomqvist K.
        Social support and its association with health-related quality of life among older patients with chronic heart failure.
        Eur J Cardiovasc Nurs. 2013; 12 (Epub 2012 Mar 28): 69-77
        • Gallagher R.
        • Luttik M.L.
        • Jaarsma T.
        Social support and self-care in heart failure.
        J Cardiovasc Nurs. 2011; 26: 439-445
        • Wu J.R.
        • Moser D.K.
        • Chung M.L.
        • Lennie T.A.
        Predictors of medication adherence using a multidimensional adherence model in patients with heart failure.
        J Card Fail. 2008; 14: 603-614
        • Schulz R.
        • Beach S.R.
        Caregiving as a risk factor for mortality: the Caregiver Health Effects Study.
        J Am Med Assoc. 1999; 282: 2215-2219
        • Christakis N.
        • Allison P.
        Mortality after the hospitalization of a spouse.
        N Engl J Med. 2006; 354: 719-730
        • Montgomery R.V.
        • Stull D.E.
        • Borgatta E.F.
        Measurement and the analysis of burden.
        Res Aging. 1985; 7: 137-152
        • Luttik M.L.
        • Jaarsma T.
        • Tijssen J.G.
        • van Veldhuisen D.J.
        • Sanderman R.
        The objective burden in partners of heart failure patients: development and initial validation of the Dutch Objective Burden Inventory.
        Eur J Cardiovasc Nurs. 2008; 7: 3-9
        • Luttik M.L.
        • Jaarsma T.
        • Veeger N.
        • et al.
        Caregiver burden in partners of Heart Failure patients: limited influence of disease severity.
        Eur J Heart Fail. 2007; 9: 695-701
        • Given C.W.
        • Given B.
        • Stommel M.
        • et al.
        The caregiver reaction assessment (CRA) for caregivers to persons with chronic physical and mental impairments.
        Res Nurs Health. 1992; 15: 271-283
        • Hughes T.B.
        • Black B.S.
        • Albert M.
        • et al.
        Correlates of objective and subjective measures of caregiver burden among dementia caregivers: influence of unmet patient and caregiver dementia-related care needs.
        Int Psychogeriatr. 2014 Nov; 26 (Epub 2014 Aug 8): 1875-1883
        • Campbell T.L.
        The effectiveness of family interventions for physical disorders.
        J Marital Fam Ther. 2003; 29: 263-281
        • Martire L.M.
        • Martire L.M.
        • Lustig A.P.
        • Schulz R.
        • Miller G.E.
        • Helgeson V.S.
        Is it beneficial to involve a family member? A meta-analysis of psychosocial interventions for chronic illness.
        Health Psychol. 2004 Nov; 23: 599-611
        • Hartmann M.
        • Bäzner E.
        • Wild B.
        • Eisler I.
        • Herzorg W.
        Effects of interventions involving the family in the treatment of adult patients with chronic physical diseases; a meta-analysis.
        Psychother Psychosom. 2010; 79: 136-148
        • Agren S.
        • Berg S.
        • Svedjeholm R.
        • Strömberg A.
        Psychoeducational support to post cardiac surgery heart failure patients and their partners – a randomised pilot study Intensive & Critical Care Nursing.
        Intensive Crit Care Nurs. 2015; 31: 10-18
        • Julious S.A.
        Sample size of 12 per group rule of thumb for a pilot study.
        Pharm Stat. 2005; 4: 287-291
        • Elmstahl S.
        • Malmberg B.
        • Annerstedt L.
        Caregiver's burden of patients 3 years after stroke assessed by a novel caregiver burden scale.
        Arch Phys Med Rehabil. 1996; 77: 177-182
        • Makdessi A.
        • Harkness K.
        • Luttik M.L.
        • McKelvie R.S.
        The Dutch Objective Burden Inventory: validity and reliability in a Canadian population of caregivers for people with heart failure.
        Eur J Cardiovasc Nurs. 2011; 10 (Epub 2010 Oct 2): 234-240
        • Agren S.
        • Evangelista L.S.
        • Hjelm C.
        • Stromberg A.
        Dyads affected by chronic heart failure: a randomized study evaluating effects of education and psychosocial support to patients with heart failure and their partners.
        J Card Fail. 2012; 18 (Epub 2012 Mar 2): 359-366
        • Archbold P.G.
        • Stewart B.J.
        • Miller L.L.
        • et al.
        The PREP system of nursing interventions: a pilot test with families caring for older members. Preparedness (PR), enrichment (E) and predictability (P).
        Res Nurs Health. 1995; 18: 3-16
        • McKee K.
        • Spazzafumo L.
        • Nolan M.
        • Wojszel B.
        • Lamura G.
        • Bien B.
        Components of the difficulties, satisfactions and management strategies of carers of older people: principal component analysis of CADI-CASI-CAMI.
        Aging Ment Health. 2009; 13: 255-264
        • Pressler S.J.
        • Gradus-Pizlo I.
        • Chubinski S.D.
        • et al.
        Family caregivers of patients with heart failure: a longitudinal study.
        J Cardiovasc Nurs. 2013; 28: 417-428
        • Bastawrous M.
        Caregiver burden – a critical discussion.
        Int J Nurs Stud. 2013; 50 (Epub 2012 Nov 3): 431-441
        • Chung M.L.
        • Moser D.K.
        • Lennie T.A.
        • Rayens M.K.
        The effects of depressive symptoms and anxiety on quality of life in patients with heart failure and their spouses: testing dyadic dynamics using Actor-Partner Interdependence Model.
        J Psychosom Res. 2009; 67: 29-35