Bidwell Julie T, Fauer Alex J, Howe Rebecca J, Saylor Martha Abshire, Lee Christopher S, López Javier E, Godden Monica, Hinton Ladson
J Cardiovasc Nurs. 2025 Mar 28. doi: 10.1097/JCN.0000000000001210.
Comparatively less research has been done on caregiving for persons with cardiovascular disease (CVD) than in other chronic conditions, leaving gaps in guidance for clinical care and interventions.
We aimed to describe the care needs of older adults with CVD in the United States and identify determinants of stress and mental health in their care partners.
This was a cross-sectional analysis using the National Health and Aging Trends Study (n = 1011 persons with CVD) and the National Study of Caregiving (n = 510 CVD care partners). We compared differences in health and care needs of persons with and without CVD and described care partners' caregiving activities. Using multivariate regression, we examined determinants of care partner stress and anxiety/depression.
Persons with CVD had higher comorbid burden, worse health, and more care needs than those without CVD. Most care partners helped with activities of daily living in addition to disease-related care. Worse stress was associated with worse care partner health (β = 0.357; 95% confidence interval [CI], 0.192-0.522), more care activities (β = 0.388; CI, 0.070-0.705), greater care coordination (β = 0.367; CI, 0.012-0.722), more medical/nursing tasks (β = 0.489; CI, 0.145-0.834), and poorer relationship quality with the care recipient (β = -0.269; CI, -0.365 to -0.173). Care partners were more likely to have anxiety/depression if their care recipient had poorer mental health (odds ratio [OR], 1.137; CI, 1.017-1.270), whereas better relationship quality and higher educational attainment appeared protective (OR, 0.837 [CI, 0.719-0.975], and OR, 0.170 [CI, 0.076-0.380], respectively).
Our findings suggest a need for broader examination of caregiving burden in CVD, well beyond CVD-specific aspects.
与其他慢性病相比,针对心血管疾病(CVD)患者的照护研究相对较少,这导致临床护理和干预指导方面存在空白。
我们旨在描述美国老年CVD患者的照护需求,并确定其照护伙伴压力和心理健康的决定因素。
这是一项横断面分析,使用了国家健康与老龄化趋势研究(n = 1011名CVD患者)和国家照护研究(n = 510名CVD照护伙伴)。我们比较了有和没有CVD的人群在健康和照护需求方面的差异,并描述了照护伙伴的照护活动。使用多变量回归,我们研究了照护伙伴压力和焦虑/抑郁的决定因素。
与没有CVD的人相比,CVD患者有更高的共病负担、更差的健康状况和更多的照护需求。大多数照护伙伴除了提供与疾病相关的照护外,还帮助进行日常生活活动。更严重的压力与照护伙伴更差的健康状况(β = 0.357;95%置信区间[CI],0.192 - 0.522)、更多的照护活动(β = 0.388;CI,0.070 - 0.705)、更大的照护协调(β = 0.367;CI,0.012 - 0.722)、更多的医疗/护理任务(β = 0.489;CI,0.145 - 0.834)以及与受照护者更差的关系质量(β = -0.269;CI,-0.365至-0.173)相关。如果照护伙伴的受照护者心理健康状况较差,那么照护伙伴更有可能出现焦虑/抑郁(优势比[OR],1.137;CI,1.017 - 1.2