Patient and informal caregiver-centered nursing interventions for adults with heart failure: A systematic review and meta-analysis

Abstract

Background

Heart failure management requires active participation in self-care by both patients and family caregivers as a dyad.

Objective

This systematic review and meta-analysis aimed to examine the impact of dyadic self-care interventions on patient outcomes in heart failure management.

Methods

We searched databases including PubMed, Embase, Cochrane Library, Web of Science, CINAHL, CNKI, and Wanfang through May 14, 2024. Following PRISMA guidelines, we used the Cochrane Risk of Bias tool for quality assessment and Review Manager 5.4 for data analysis.

Results

Twenty studies (18 Randomized Controlled Trials, 2 quasi-experimental) involving 3,266 patients and 3,091 family caregivers were included. Dyadic self-care interventions showed significant effects on patients’ self-care maintenance (MD: 9.07, 95 % CI: 6.17–11.98) and management (MD: 5.03, 95 % CI: 3.96–6.10) across all time periods. Self-care confidence improved only in short-term (MD: 6.32, 95 % CI: 5.32–7.32) and medium-term (MD: 4.23, 95 % CI: 0.26–8.20). Quality of life improved only in short-term. The interventions reduced readmission rates and healthcare costs but showed no effect on mortality, anxiety, or depression.

Conclusions

Dyadic interventions effectively reduced readmissions and improved quality of life in heart failure management. Future research should focus on sustainable, cost-effective strategies for long-term outcomes.

Implications for clinical practice

The findings support implementing dyadic interventions while emphasizing the need for continued focus on mental health and sustained support. Further research on caregiver outcomes is warranted.