Caregiver Social Problem Solving Abilities and Family Member Adjustment Following Congestive Heart Failure

Kurylo, Monica; Elliott, Timothy R.; DeVivo, Lisa; Dreer, Laura E.

doi:10.1023/b:jocs.0000037609.23007.24

Cited by 26 publications

(29 citation statements)

References 33 publications

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Section: Hf Caregiver Burden and Outcomesmentioning

confidence: 99%

“…Thus, the family structure, family functioning (eg, communication, adaptability, and problem solving), and family support are hypothesized to specifically influence the HF patient's behavioral characteristics as well as directly affect self-care. 31,64,65,72 Caregiver outcomes are important as well and include caregiver burden and health status. 49,57 In many of the HF caregiver studies, the focus has been on emotional state; however, physical health is also important, especially with elderly caregivers.…”

Section: Hf Caregiver Burden and Outcomesmentioning

confidence: 99%

“…14,64 Negative caregiver problem-solving abilities have been found to be significantly predictive of higher levels of depression and decreased life satisfaction in the patient with HF. 65 Thus, the caregiver's preparation, confidence, and problem-solving approach influence the self-care outcomes directly or may possibly affect the patient's emotional state and their subsequent self-care activities.Caregivers may experience increased burden when new devices or treatment practices are introduced, 66,67 and, for example, a study of home-based exercise to improve functional status of the HF patient resulted in increased caregiver burden. 68 Caregivers may also experience distressing symptoms such as sleep difficulties related to the HF patient's sleep apnea or sleep difficulties.…”

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confidence: 99%

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Family Influences on Heart Failure Self-care and Outcomes

Dunbar

Clark

Quinn

et al. 2008

Journal of Cardiovascular Nursing

236

234

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Many patient education guidelines for teaching heart failure patients recommend inclusion of the family; however, family-focused interventions to promote self-care in heart failure are few. This article reviews the state of the science regarding family influences on heart failure self-care and outcomes. The literature and current studies suggest that family functioning, family support, problem solving, communication, self-efficacy, and caregiver burden are important areas to target for future research. In addition, heart failure patients without family and those who live alone and are socially isolated are highly vulnerable for poor self-care and should receive focused attention. Specific research questions based on existing science and gaps that need to be filled to support clinical practice are posed.Keywords caregiver outcomes; family functioning; family support; heart failure; patient education; self-care; self-management Efforts to bolster self-care in heart failure (HF) patients are paramount to improving behaviors related to diet and medication adherence, reducing hospitalization, and enhancing overall outcomes. Self-care in HF is quite variable, and new approaches are needed to promote preventable hospitalizations, reduce symptoms, and improve quality of life. Published clinical practice guidelines suggest that both patients with HF and their family members or care-givers should receive individualized education and counseling that emphasizes self-care 1 ; however, the data to guide family education and care in HF are sparse. This review will examine the literature related to HF self-care and family concepts including descriptive research on family variables and behaviors, the relationship of family variables to outcomes, and family intervention studies. Finally, recommendations for HF practice and future research will be presented. Copyright NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptThe concept of family is highly relevant to self-care, and a recent framework published by Grey and colleagues 2 outlines the relationships among family factors, individual, and family selfmanagement of chronic illness. Using a structure, process, and out-comes framework, the model identifies family structural variables as risk and protective factors that influence individual and family self-care and self-management behaviors as part of health promotion or chronic disease care. These behaviors, such as healthy eating or medication-taking activities, then lead to clinical outcomes. Family functioning (which has dimensions of adaptability, problem solving, and communication and roles) in this model also is viewed as an outcome of self-management; however, in other chronic illness populations, family functioning is often understood as a precursor to effective self-care. Regardless of where it is placed in models, when family functioning is not optimal, managing a complex self-care regimen, such as that prescribed for HF patients, will not be as effective as it could be. Better family fun...

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Section: Hf Caregiver Burden and Outcomesmentioning

confidence: 99%

Section: Hf Caregiver Burden and Outcomesmentioning

confidence: 99%

mentioning

confidence: 99%

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Family Influences on Heart Failure Self-care and Outcomes

Dunbar

Clark

Quinn

et al. 2008

Journal of Cardiovascular Nursing

236

234

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“…Prospective research has shown that caregivers who have ineffective problem solving abilities at the time a family member incurs a physical disability are more likely to experience higher levels of depression, anxiety, and ill health throughout the initial year of caregiving (Elliott, Shewchuk, & Richards, 2001). When a caregiver has difficulty solving problems of everyday life, the health of the care recipient may be at risk: Ineffective problem-solving abilities among caregivers have been significantly associated with higher depression and lower life satisfaction among persons with congestive heart failure (Kurylo, Elliott, DeVivo, & Dreer, 2004). Moreover, an impulsive and careless problem-solving style among caregivers has been prospectively and significantly predictive of pressure sores occurrence among persons with SCI over the course of a year (Elliott, Shewchuk, & Richards, 1999).…”

Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

Family Caregivers of Women with Physical Disabilities

Rivera

Elliott

Berry

et al. 2006

J Clin Psychol Med Settings

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Cross-sectional, correlational analyses of data from two separate studies were conducted to examine the correlates of adjustment among family caregivers of women with disabilities. Participants included 40 caregivers of women with spinal cord injuries in the first study and 53 caregivers of women with cerebral palsy, traumatic brain injury, and other neuromuscular disabilities in the second study. It was hypothesized that a negative problem-solving style would be associated with greater caregiver distress in both studies, and that caregiver adjustment would be associated with care recipient depression in the second study. As expected, results indicated that a higher negative orientation toward solving problems was associated with caregiver depression and lower well-being. However, in the second study, caregiver characteristics were not associated with care recipient depression. These data indicate that considerable variability exists in caregiver adjustment. Methodological limitations and the implications for research, service, and policy formation are! discussed. KeywordsCaregiver; Women; Disability Family caregivers of women with physical disabilitiesAs health care programs continue to circumscribe their service to persons with chronic, debilitating health conditions, many family members are compelled to assume caregiving roles (Hoffman, Rice, & Sung, 1996). In fact, available data indicate that family caregivers " … constitute the largest group of care providers" in the United States (Parish, Pomeranz-Essley, & Braddock, 2003, p. 174), and as they provide the majority of long-term care in this country, the market value of their activity far exceeds that spent on formal health care and nursing home care (Vitaliano, Young, & Zhang, 2004, p. 13). Yet family caregivers function as de facto healthcare providers without adequate training or appropriate remuneration (Shewchuk & Elliott, 2000): They are expected to operate competently as extensions of health care systems, often performing complex medical and therapeutic tasks, helping a loved one perform and adhere to therapeutic regimens .Caregiving is often associated with many deleterious effects on the caregiver (Donelan, Falik, & DesRoaches, 2001;Vitaliano, Zhang, & Scanlan, 2003). However, this work has been largely Correspondence to: Patricia A. Rivera. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript restricted to studies of care recipients who have degenerative diseases (e.g., Alzheimer's disease, dementias). These experiences are ultimately time-limited, contingent upon the eventual progression of the disease. The stress of these caregiving scenarios is unlike that associated with assisting individuals with permanently and severely disabling conditions, in which the care recipient is impaired but has a considerable life expectancy. To date, little research has addressed the impact of caregiving for people with severe physical disabilities who now have considerable life expectancies, and the research that...

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“…Cela réfère plus précisément à l'évaluation subjective du conjoint de sa relation maritale (Burman & Margolin, 1992). Ces dernières études font ressortir que la qualité de la relation maritale est un facteur important affectant la condition de santé des patients coronariens.Effectivement, la qualité de la relation maritale affecte la santé cardiovasculaire des (Campbell, 2003;Fiscella et al, 1997;Fisher & Weihs, 2000;Kurylo et al, 2004;Wang & Fenske, 1996;Wang et al, 2005). Malgré les multiples facettes positives du soutien familial liées à la santé des patients coronariens, il existe également des côtés néfastes reliés au soutien familial, plus précisément lorsqu'il y a surprotection auprès des patients.…”

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Relations entre le soutien aux besoins d'autonomie et de compétence par la famille, la motivation autodéterminée spécifique à l'activité physique et à l'alimentation saine et la santé psychologique de patients coronariens du Saguenay-Lac-Saint-Jean /

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2013

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pour le modèle 1 et de 0,053 pour le modèle 2) (le soutien aux deux besoins et la motivation spécifique à ces deux comportements de santé expliquant ensemble 25,4 % de la variance de la santé psychologique). Enfin, les résultats n'ont pas permis d'établir que le soutien au besoin d'autonomie par la famille a un plus grand impact sur la motivation autodéterminée spécifique à l'activité physique et à l'alimentation saine des patients coronariens que le soutien au besoin de compétence par la famille (le coefficient de prédiction standardisé associé au soutien de compétence étant de 0,28 pour la motivation à l'activité physique et de 0,31 pour la motivation à l'alimentation saine et le coefficient de prédiction standardisé associé au soutien à l'autonomie étant de 0,20 pour la motivation à l'activité physique et de 0,22 pour la motivation à l'alimentation saine).La recherche actuelle, en plus d'offrir un appui empirique quant à la présence de relations entre certaines variables explorées par la TAD et la santé psychologique, permet d'apporter de nouvelles connaissances et ainsi d'améliorer notre compréhension de la santé psychologique de patients coronariens. Cette meilleure compréhension contribue à la diffusion de recommandations quant aux plans de réhabilitation de ces patients. Table des matièresSommaire ii femmes, ce qui représente le tiers du nombre total de tous les décès. Les MCV constituent la catégorie de maladie qui est la plus coûteuse sur le plan économique pour le système de santé québécois (Daigle, 2006). À ces égards, les MCV constituent donc un intérêt majeur pour la population, les professionnels et les chercheurs du domaine de la santé. Afin d'aider les patients à modifier leurs habitudes de vie et ainsi adopter des comportements de santé, les recherches dans le domaine de la santé ont en outre étudié la motivation de diverses populations. Deci et Ryan (1985 proposent une théorie de la motivation humaine, la théorie de l'autodétermination (TAD), laquelle permet de mieux comprendre les processus sous-jacents à la motivation autodéterminée spécifique à l'adoption de comportements de santé. Par l'entremise de ses nombreuses recherches appuyant empiriquement ses principes fondamentaux, la TAD a notamment démontré dans le domaine de la santé que lorsque les besoins d'autonomie, de compétence et d'affiliation sociale sont soutenus par le personnel soignant, cela amène une motivation autodéterminée spécifique à des comportements de santé ainsi qu'un maintien de ces mêmes comportements chez les patients, d'où en résultent des effets positifs sur leur santé physique et mentale (Sheldon, Williams, & Joiner, 2003).La présente étude vise à vérifier les liens unissant le soutien par la famille à deux besoins identifiés par la TAD (autonomie et compétence), la motivation autodéterminée spécifique à l'activité physique et à l'alimentation saine et la santé psychologique chez une population coronarienne du Saguenay-Lac-Saint-Jean (SLSJ). Aucune étude ne s'est intéressée aux relations entre le soutien à ces besoi...

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Caregiver Social Problem Solving Abilities and Family Member Adjustment Following Congestive Heart Failure

Cited by 26 publications

References 33 publications

Family Influences on Heart Failure Self-care and Outcomes

Family Influences on Heart Failure Self-care and Outcomes

Family Caregivers of Women with Physical Disabilities

Relations entre le soutien aux besoins d'autonomie et de compétence par la famille, la motivation autodéterminée spécifique à l'activité physique et à l'alimentation saine et la santé psychologique de patients coronariens du Saguenay-Lac-Saint-Jean /

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