Association of Patient Reported Outcomes With Caregiver Burden in Older Patients With Advanced Heart Failure: Insights From the SUSTAIN-IT Study.

IF 7.8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Circulation: Heart Failure Pub Date : 2024-07-01 Epub Date: 2024-06-24 DOI:10.1161/CIRCHEARTFAILURE.124.011705

Dan D Nguyen, John A Spertus, Mary C Benton, Merrill Thomas, Philip G Jones, Adin-Cristian Andrei, Tingqing Wu, Abigail S Baldridge, Kathleen L Grady

{"title":"Association of Patient Reported Outcomes With Caregiver Burden in Older Patients With Advanced Heart Failure: Insights From the SUSTAIN-IT Study.","authors":"Dan D Nguyen, John A Spertus, Mary C Benton, Merrill Thomas, Philip G Jones, Adin-Cristian Andrei, Tingqing Wu, Abigail S Baldridge, Kathleen L Grady","doi":"10.1161/CIRCHEARTFAILURE.124.011705","DOIUrl":null,"url":null,"abstract":"Background: Caregivers of patients with advanced heart failure may experience burden in providing care, but whether changes in patient health status are associated with caregiver burden is unknown.Methods: This observational study included older patients (60-80 years old) receiving advanced surgical heart failure therapies and their caregivers at 13 US sites. Patient health status was assessed using the 12-item Kansas City Cardiomyopathy Questionnaire (range, 0-100; higher scores are better). Caregiver burden was assessed using the Oberst Caregiving Burden Scale, which measures time on task (OCBS-time) and task difficulty (OCBS-difficulty; range, 1-5; lower scores are better). Measurements occurred before surgery and 12 months after in 3 advanced heart failure cohorts: patients receiving long-term left ventricular assist device support; heart transplantation with pretransplant left ventricular assist device support; and heart transplantation without pretransplant left ventricular assist device support. Multivariable linear regression was used to identify predictors of change in OCBS-time and OCBS-difficulty at 12 months.Results: Of 162 caregivers, the mean age was 61.0±9.4 years, 139 (86%) were female, and 140 (86%) were the patient's spouse. At 12 months, 99 (61.1%) caregivers experienced improved OCBS-time, and 61 (37.7%) experienced improved OCBS-difficulty (versus no change or worse OCBS). A 10-point higher baseline 12-item Kansas City Cardiomyopathy Questionnaire predicted lower 12-month OCBS-time (β=-0.09 [95% CI, -0.14 to -0.03]; P<0.001) and OCBS-difficulty (β=-0.08 [95% CI, -0.12 to -0.05]; P<0.001). Each 10-point improvement in the 12-item Kansas City Cardiomyopathy Questionnaire predicted lower 12-month OCBS-time (β=-0.07 [95% CI, -0.12 to -0.03]; P=0.002) and OCBS-difficulty (β=-0.09 [95% CI, -0.12 to -0.06]; P<0.001).Conclusions: Among survivors at 12 months, baseline and change in patient health status were associated with subsequent caregiver time on task and task difficulty in dyads receiving advanced heart failure surgical therapies, highlighting the potential for serial 12-item Kansas City Cardiomyopathy Questionnaire assessments to identify caregivers at risk of increased burden.Registration: URL: https://www.clinicaltrials.gov; unique identifier: NCT02568930.","PeriodicalId":10196,"journal":{"name":"Circulation: Heart Failure","volume":" ","pages":"e011705"},"PeriodicalIF":7.8000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Circulation: Heart Failure","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1161/CIRCHEARTFAILURE.124.011705","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/24 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Caregivers of patients with advanced heart failure may experience burden in providing care, but whether changes in patient health status are associated with caregiver burden is unknown.

Methods: This observational study included older patients (60-80 years old) receiving advanced surgical heart failure therapies and their caregivers at 13 US sites. Patient health status was assessed using the 12-item Kansas City Cardiomyopathy Questionnaire (range, 0-100; higher scores are better). Caregiver burden was assessed using the Oberst Caregiving Burden Scale, which measures time on task (OCBS-time) and task difficulty (OCBS-difficulty; range, 1-5; lower scores are better). Measurements occurred before surgery and 12 months after in 3 advanced heart failure cohorts: patients receiving long-term left ventricular assist device support; heart transplantation with pretransplant left ventricular assist device support; and heart transplantation without pretransplant left ventricular assist device support. Multivariable linear regression was used to identify predictors of change in OCBS-time and OCBS-difficulty at 12 months.

Results: Of 162 caregivers, the mean age was 61.0±9.4 years, 139 (86%) were female, and 140 (86%) were the patient's spouse. At 12 months, 99 (61.1%) caregivers experienced improved OCBS-time, and 61 (37.7%) experienced improved OCBS-difficulty (versus no change or worse OCBS). A 10-point higher baseline 12-item Kansas City Cardiomyopathy Questionnaire predicted lower 12-month OCBS-time (β=-0.09 [95% CI, -0.14 to -0.03]; P<0.001) and OCBS-difficulty (β=-0.08 [95% CI, -0.12 to -0.05]; P<0.001). Each 10-point improvement in the 12-item Kansas City Cardiomyopathy Questionnaire predicted lower 12-month OCBS-time (β=-0.07 [95% CI, -0.12 to -0.03]; P=0.002) and OCBS-difficulty (β=-0.09 [95% CI, -0.12 to -0.06]; P<0.001).

Conclusions: Among survivors at 12 months, baseline and change in patient health status were associated with subsequent caregiver time on task and task difficulty in dyads receiving advanced heart failure surgical therapies, highlighting the potential for serial 12-item Kansas City Cardiomyopathy Questionnaire assessments to identify caregivers at risk of increased burden.

Registration: URL: https://www.clinicaltrials.gov; unique identifier: NCT02568930.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

晚期心力衰竭老年患者的患者报告结果与护理人员负担的关系：SUSTAIN-IT研究的启示

背景：晚期心力衰竭患者的护理者在提供护理时可能会感到负担沉重，但患者健康状况的变化是否与护理者的负担有关尚不清楚：晚期心力衰竭患者的护理者在提供护理时可能会有负担，但患者健康状况的变化是否与护理者的负担相关尚不清楚：这项观察性研究纳入了在美国 13 个地点接受晚期心力衰竭手术治疗的老年患者（60-80 岁）及其护理人员。患者健康状况由 12 个项目的堪萨斯城心肌病问卷（范围为 0-100；分数越高越好）评估。护理人员的负担采用奥伯斯特护理负担量表进行评估，该量表测量任务时间（OCBS-time）和任务难度（OCBS-difficulty；范围为 1-5；分数越低越好）。在手术前和手术后12个月对3个晚期心力衰竭组群进行了测量：长期接受左心室辅助装置支持的患者；移植前接受左心室辅助装置支持的心脏移植患者；移植前未接受左心室辅助装置支持的心脏移植患者。多变量线性回归用于确定12个月时OCBS时间和OCBS难度变化的预测因素：在162名护理人员中，平均年龄为（61.0±9.4）岁，139人（86%）为女性，140人（86%）为患者配偶。12个月后，99名护理人员（61.1%）的OCBS时间有所改善，61名护理人员（37.7%）的OCBS难度有所改善（相比之下，护理人员的OCBS没有变化或有所恶化）。12 项堪萨斯城心肌病问卷基线分值高 10 分，则 12 个月的 OCBS 时间（β=-0.09 [95% CI, -0.14 to -0.03]；PPP=0.002）和 OCBS 难度（β=-0.09 [95% CI, -0.12 to -0.06]；PConclusions：在接受晚期心力衰竭手术治疗的幸存者中，12个月时患者健康状况的基线和变化与随后照顾者的任务时间和任务难度有关，这突出了连续12项堪萨斯城心肌病问卷评估的潜力，以确定有增加负担风险的照顾者：URL: https://www.clinicaltrials.gov; 唯一标识符：NCT02568930。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Circulation: Heart Failure 医学-心血管系统

CiteScore

12.90

自引率

3.10%

发文量

271

审稿时长

6-12 weeks

期刊介绍： Circulation: Heart Failure focuses on content related to heart failure, mechanical circulatory support, and heart transplant science and medicine. It considers studies conducted in humans or analyses of human data, as well as preclinical studies with direct clinical correlation or relevance. While primarily a clinical journal, it may publish novel basic and preclinical studies that significantly advance the field of heart failure.