心力衰竭患者-照护者对双方关系、焦虑和抑郁的关联：演员-伙伴相互依存模型分析。
The Association Between Mutuality, Anxiety, and Depression in Heart Failure Patient-Caregiver Dyads: An Actor-Partner Interdependence Model Analysis.
机构信息
Federica Dellafiore, PhD, RN PhD, Department of Biomedicine and Prevention, University of Rome Tor Vergata; Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milan, Italy. Misook L. Chung, PhD, RN, FAAN, FAHA Professor, College of Nursing, University of Kentucky, Lexington. Rosaria Alvaro, MSN, RN, FESC Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Durante Angela, PhD, RN Postdoctoral Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Sofia Colaceci, PhD Research Fellow, Saint Camillus International University of Health and Medical Sciences, Rome, Italy. Ercole Vellone, RN, PhD, FESC Associate Professor, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy. Gianluca Pucciarelli, PhD, RN Postdoctoral Research Fellow, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy.
出版信息
J Cardiovasc Nurs. 2019 Nov/Dec;34(6):465-473. doi: 10.1097/JCN.0000000000000599.
BACKGROUND
Heart failure (HF) patient-caregiver dyads experience severe psychological problems, such as anxiety and depression. A variable that has been found to be associated with anxiety and depression in patients and caregivers in severe chronic conditions is mutuality. However, this association has not been explored in HF patient-caregiver dyads to date.
OBJECTIVE
The aim of this study was to evaluate the associations among mutuality, anxiety, and depression in HF patient-caregiver dyads.
METHODS
This was a cross-sectional study. Mutuality, anxiety, and depression in HF patient-caregiver dyads were assessed using the Mutuality Scale (MS) total and 4 dimension scores and the Hospital Anxiety and Depression Scale, respectively. Data were analyzed using the actor-partner interdependence model to examine how mutuality of patients and caregivers was associated with both the patients' own (actor effect) and their partners' anxiety and depression (partner effect).
RESULTS
A sample of 366 dyads of patients with HF (mean age, 72 years; 56% male) and caregivers (mean age, 54 years; 73.3% female) was enrolled. Regarding patient anxiety, we observed only an actor effect between the MS dimension scores of "love and affection" and "reciprocity" and anxiety in patients (B = -1.108, P = .004 and B = -0.826, P = .029, respectively). No actor and partner effects were observed concerning caregiver anxiety. Regarding depression, we observed that only the MS dimension of "love and affection" in patients had both an actor (patient: B = -0.717, P = .032) and a partner (caregiver: B = 0.710, P = .040) effect on depression.
CONCLUSIONS
The assessment of MS in HF patient-caregiver dyads is important to formulate interventions aimed at improving anxiety and depression in patients and caregivers.
背景
心力衰竭（HF）患者-照顾者对经历严重的心理问题，如焦虑和抑郁。在严重慢性疾病的患者和照顾者中，与焦虑和抑郁相关的一个变量是相互性。然而，迄今为止，尚未在 HF 患者-照顾者对中探讨这种相关性。
目的
本研究旨在评估 HF 患者-照顾者对中相互性、焦虑和抑郁之间的相关性。
方法
这是一项横断面研究。使用相互性量表（MS）总分和 4 个维度评分以及医院焦虑抑郁量表分别评估 HF 患者-照顾者对中相互性、焦虑和抑郁。使用演员-伙伴相互依赖模型分析数据，以评估患者和照顾者的相互性如何与患者自身（演员效应）和他们的伙伴的焦虑和抑郁（伙伴效应）相关。
结果
共纳入 366 对 HF 患者（平均年龄 72 岁，56%为男性）和照顾者（平均年龄 54 岁，73.3%为女性）。关于患者焦虑，我们仅观察到 MS“爱与感情”和“互惠”维度得分与患者焦虑之间存在演员效应（B = -1.108，P =.004 和 B = -0.826，P =.029）。关于照顾者焦虑，未观察到演员和伙伴效应。关于抑郁，我们观察到仅患者的 MS“爱与感情”维度对患者和照顾者的抑郁均具有演员（患者：B = -0.717，P =.032）和伙伴（照顾者：B = 0.710，P =.040）效应。
结论
在 HF 患者-照顾者对中评估 MS 对于制定旨在改善患者和照顾者焦虑和抑郁的干预措施非常重要。
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