Hooker Stephanie A, Grigsby Megan E, Riegel Barbara, Bekelman David B
Stephanie A. Hooker, MS Doctoral Student, Department of Psychology, University of Colorado Denver. Megan E. Grigsby, BA Doctoral Student, Department of Psychology, University of Colorado Denver. Barbara Riegel, PhD, RN, FAHA, FAAN Professor of Nursing, Edith Clemmer Steinbreight Chair of Gerontology, and Director, School of Nursing, Biobehavioral Research Center, University of Pennsylvania, Philadelphia. David B. Bekelman, MD, MPH Associate Professor of Medicine and Nursing, Department of Veterans Affairs, Eastern Colorado Health Care System, Denver; Department of Medicine and College of Nursing, University of Colorado School of Medicine at the Anschutz Medical Campus, Aurora.
J Cardiovasc Nurs. 2015 Jul-Aug;30(4 Suppl 1):S52-63. doi: 10.1097/JCN.0000000000000270.
Relationships can have positive and negative impacts on health and well-being. Dyadic relationships between heart failure (HF) patients and their informal family caregivers may affect both patient and caregiver outcomes.
The aim of this study is to synthesize the literature to date on the associations between HF patient-caregiver relationship quality and communication and patient and caregiver health outcomes.
An integrative review of the literature was conducted. Computerized literature searches in Medline, PsycInfo, CINAHL, Web of Science, and EMBASE yielded 13 articles of HF patients and caregivers. Included articles were reviewed and double-coded by 2 independent coders.
Included articles measured relationship quality or aspects of communication within an HF patient-caregiver dyad and used both cross-sectional and longitudinal designs. Results of the longest prospective study suggested that better relationship quality between HF patients and their informal family caregivers was related to a reduced risk for mortality in patients. Results of 11 of the 12 other studies were consistent to the reference study, suggesting that better relationship quality and communication were related to reduced mortality, increased health status, less distress, and lower caregiver burden.
Relationship quality and communication seem to matter in the health and well-being of both HF patients and their informal family caregivers. More research is needed to elucidate mechanisms and to design effective relationship-focused interventions.
人际关系会对健康和幸福产生积极和消极的影响。心力衰竭（HF）患者与其非正式家庭照顾者之间的二元关系可能会影响患者和照顾者的结局。
本研究的目的是综合迄今为止关于HF患者-照顾者关系质量与沟通以及患者和照顾者健康结局之间关联的文献。
对文献进行综合综述。在Medline、PsycInfo、CINAHL、科学网和EMBASE中进行计算机文献检索，得到13篇关于HF患者和照顾者的文章。纳入的文章由2名独立编码员进行审查和双重编码。
纳入的文章测量了HF患者-照顾者二元组内的关系质量或沟通方面，并采用了横断面和纵向设计。最长的前瞻性研究结果表明，HF患者与其非正式家庭照顾者之间更好的关系质量与患者死亡风险降低有关。其他12项研究中的11项结果与参考研究一致，表明更好的关系质量和沟通与降低死亡率、提高健康状况、减少痛苦和减轻照顾者负担有关。
关系质量和沟通似乎对HF患者及其非正式家庭照顾者的健康和幸福都很重要。需要更多的研究来阐明机制并设计有效的以关系为重点的干预措施。
