J Cardiovasc Nurs. 2024;39(3):266-278. doi: 10.1097/JCN.0000000000001060. Epub 2024 Feb 1.
A previous systematic review reporting the contributions of informal, unpaid caregivers to patient heart failure (HF) self-care requires updating to better inform research, practice, and policy.
The aim of this study was to provide an updated review answering the questions: (1) What specific activities do informal caregivers of adults with HF take part in related to HF self-care? (2) Have the activities that informal caregivers of adults with HF take part in related to HF self-care changed over time? (3) What are the gaps in the science?
This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, CINAHL, EMBASE, and Cochrane CENTRAL databases were searched. Eligible studies involved an informal, unpaid caregiver of an adult with HF as a study variable or participant. Caregiving activities were benchmarked using the theory of self-care in chronic illness.
Two thousand one hundred fifty-four research reports were identified, of which 64 met criteria. Caregivers' contributions occurred in self-care maintenance (91%), monitoring (54%), and management (46%). Activities performed directly on or to the patient were reported more frequently than activities performed for the patient. Change over time involved the 3 domains differentially. Gaps include ambiguous self-care activity descriptions, inadequate caregiving time quantification, and underrepresented self-care monitoring, supportive, and communication activities.
Newly identified caregiver-reported activities support updating the theory of self-care in chronic illness to include activities currently considered ancillary to HF self-care. Identified gaps highlight the need to define specific caregiving activities, determine task difficulty and burden, and identify caregiver self-care strategy and education needs. Exposing the hidden work of caregiving is essential to inform policy and practice.
之前有一项系统评价报告了非专业、无偿照护者对心力衰竭（HF）患者自我护理的贡献，该评价需要更新，以便更好地为研究、实践和政策提供信息。
本研究旨在提供一份更新的综述，回答以下问题：（1）HF 自我护理的成年患者的非专业照护者具体参与了哪些活动？（2）HF 自我护理的成年患者的非专业照护者参与的活动是否随时间发生了变化？（3）该领域的科学研究存在哪些空白？
本综述遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。检索了 PubMed、CINAHL、EMBASE 和 Cochrane CENTRAL 数据库。合格的研究涉及成年 HF 患者的非正式、无偿照护者作为研究变量或参与者。使用慢性病自我护理理论对标照护者的活动。
共确定了 2154 篇研究报告，其中 64 篇符合标准。照护者的贡献发生在自我护理维持（91%）、监测（54%）和管理（46%）。直接针对患者或为患者进行的活动比为患者进行的活动报告得更频繁。随时间的变化涉及 3 个领域的差异。差距包括自我护理活动描述不明确、照护时间量化不足以及自我护理监测、支持和沟通活动代表性不足。
新确定的照护者报告的活动支持更新慢性病自我护理理论，将目前被认为是 HF 自我护理辅助的活动纳入其中。已确定的差距突出表明需要定义具体的照护活动、确定任务难度和负担，以及确定照护者自我护理策略和教育需求。揭示照护的隐性工作对于为政策和实践提供信息至关重要。
