170 Improving illness collaboration, communication and confidence in adults with heart failure and their spouse/partners: results from an early-phase intervention

Abstract

Abstract Background Older adults with Heart Failure (HF) and their spouse/partner experience significant negative impact on their health and relationship. Yet, few interventions focus on the HF couple. Informed by the Theory of Dyadic Illness Management, the Taking Care of Us© (TCU) intervention was designed to improve illness collaboration, communication, and confidence within older couples living with HF. Methods A randomised controlled trial was used to explore this early-phase psychosocial intervention in comparison to an education attention-control condition. Both programs were delivered virtually over two months to couples in the United States. Thirty seven couples (adults with heart failure [AwHF] and their spouse/partners) were randomised (18 to TCU and 19 to attention-control) with 24 couples completing the follow-up assessment (12 couples per condition). AwHF were on average 69.9 (SD = 9.6) years of age, predominantly male (70%) and reported being in NYHA Stage II/III (73%). Between-group effect sizes are reported due to small sample. Results At follow-up, TCU AwHF reported bigger declines in dyspnoea (d = 0.66), pain interference (d = 1.23) and fatigue (d = 0.18) than the educational condition. Additionally, TCU couples reported greater improvements in collaborative HF management (d = 0.17 for AwHF; d = 0.40 for spouses), collaborative coping (d = 0.68 for AwHF; d = 0.49 for spouses), shared physical activity (d = 0.72 for AwHF), shared fun activities (d = 0.70 for AwHF; d = 0.52 for spouses), and communication as a couple (d = 0.38 for AwHF; d = 0.20 for spouses). TCU AwHF reported being more likely to reduce fluid (d = 0.35) and take a diuretic (d = 0.22) when needed; TCU spouses reported being more likely to recommend reducing salt (d = 0.37), fluid (d = 0.16), and taking a diuretic (d = 0.54) when needed. Finally, AwHF in the attention-control condition reported bigger improvements in confidence to manage HF (d = 0.18) than TCU AwHF. Conclusion Preliminary data of the TCU© program shows promise for improving collaboration, communication, and health in older couples with HF.