Abstract 15705: Perceived Control Over Own Health Buffers the Negative Impact of Patient Symptom Burden on Quality of Life in Patient-Caregiver Dyads: A Dyadic Mediation Analysis

Abstract

Introduction: Patients with heart failure (HF) experience multiple physical and psychological symptoms that are associated with poor quality of life (QoL) for patients and family caregivers. Perceived control is known to buffer the adverse consequences of symptom burden on QoL among patients and caregivers at the individual level. However, there is limited knowledge about these associations within dyad members. Our aim was to determine whether perceived control over one’s personal health mediated the association of patient symptom burden and QoL in each member of the dyad. Methods: In this cross-sectional study, patients with HF (N= 154, 65% male, 50% NYHA III/V) reported physical and psychological symptom burden (Memorial Symptom Assessment Scale-HF). Informal caregivers (N = 154, 76% female) and patients completed surveys of perceived control (Control Attitudes Scale-Revised) and physical and mental well-being (MOS Health Survey-36v2). Dyadic data were analyzed using four multilevel Actor Partner Independence Mediation Models. Results: Symptom burden was associated with perceived control of each dyad member (P <.05). Physical symptom burden was directly associated with physical well-being for patients, not caregivers. Physical and psychological symptom burden was directly associated with mental well-being for each dyad member. Perceived control significantly mediated the association of physical symptom burden with physical and mental well-being in each dyad member (Figures A & C). Similarly, perceived control mediated the association of psychological symptom burden with physical and mental well-being in each dyad member (Figures B & D). Perceived control did not influence QoL in partners. Conclusions: Physical and psychological symptoms in HF patients were linked with each dyad member's QoL through perceived control over their health. Fostering perceived control may minimize the negative impact of symptom burden on the QoL of dyad members.