Dyads affected by chronic heart failure : a randomised study evaluating effects of education and psychosocial support to patients and their partners

Background: Chronic heart failure (HF) may cause great suffering for both patients and their partners. High marital quality with sufficient emotional support has been found to influence long-term survival in patients with chronic HF. However, emotional reactions of burden, stress and depression have been found to be associated with the partner’s new role. Psychosocial support, and patients-partner education is usually not included in standard chronic HF care despite recommendations in international guidelines. Aim: To evaluate the effects of an integrated dyad care programme with education and psychosocial support to patients with chronic HF and their partners during a post-discharge period of 3 months after acute deterioration of chronic HF. Methods: A randomised, controlled design with a follow up assessment after 3 months was used. The dyads in the control group received care as usual. The experimental group participated in an integrated care intervention, delivered in three modules through nurse-led face-to-face counselling, a computer-based CD-ROM program and other written teaching materials. Results: The intervention improved perceived control (P<0.05) in patients, but not in the partners. There were no other significant differences between the groups with regard to the dyads’ health related quality of life and depressive symptoms, patients’ self-care behaviour and partners’ experiences of caregiver burden. Conclusion: This is the first major randomised study evaluating a programme focusing on the development of problem solving skills to assist the dyads in managing heart failure. The intervention significantly improved the level of perceived control in the patient group.funding agencies|Linkoping University||Swedish Research Council||Swedish Institute for Health Sciences||Heart and Lung Foundation||Heart and Lung Disease National Association||Lions Research Foundation||Health Sciences Centre|