Dyadic effects of perceived social support on family health and family functioning in patients with heart failure and their nearest relatives: Using the Actor-Partner Interdependence Mediation Model.

Mahdi Shamali,Hanne Konradsen,Birte Østergaard,Lara Stas,Brita Roy

doi:10.1371/journal.pone.0217970

Mahdi Shamali, Hanne Konradsen + Show 3 more

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https://doi.org/10.1371/journal.pone.0217970

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Abstract

BackgroundSocial support, family functioning and family health are essential elements in the treatment of heart failure, yet most heart failure studies focus on the pharmacological interventions. This study aimed to examine whether perceived social support from nurses is associated with better family functioning of patients with heart failure and their nearest relatives and to examine whether family health mediates this relationship.Methods and findingsA sample of 312 patients with heart failure and 312 of their nearest relatives were included in the study. The Family Functioning, Health and Social Support questionnaire was used to collect the data. Dyadic data were analysed by the Actor–Partner Interdependence Mediation Model with distinguishable dyads using structural equation modelling. Patients and nearest relatives who perceived more social support had a higher level of family health and functioned better within the family. One partner effect was found, indicating that the higher the level of family health of the nearest relative, the better the family functioning of the patient (p <0.001). Family health partially (in the patient) and completely (in the nearest relative) mediated the association between social support and family functioning.ConclusionThis study indicated that patients with heart failure and their nearest relatives who perceived more social support from nurses were more likely to have high level of family health and function better within the family. The interdependent relationships found in our study highlight a dyadic and family-oriented approach to improve family functioning in patients with heart failure.

Highlights

Heart failure (HF), a major clinical and public health problem, is becoming a leading cause of disability and death among older adults [1,2,3]
Patients from three Danish HF outpatient clinics who were confirmed to have an HF diagnosis, had left ventricular ejection fraction (LVEF) 40%, had New York Heart Association classification (NYHA) II-IV symptoms and had signed informed consent along with their nearest relatives were included in the study
Patients had higher mean scores in family functioning, family health and perceived social support compared with the nearest relatives (Table 3)

Summary

Introduction

Heart failure (HF), a major clinical and public health problem, is becoming a leading cause of disability and death among older adults [1,2,3]. Health is considered as a unit of health involving each member of the family and the family as a whole [9] It includes well-being, ill-being, values, knowledge, and healthy activities [10]. Health and family functioning play important roles in self-care behaviours, medication adherence, mortality and morbidity in patients with HF [12] through the lifestyle modifications of the family to the illness [13]. Family functioning and family health are essential elements in the treatment of heart failure, yet most heart failure studies focus on the pharmacological interventions. This study aimed to examine whether perceived social support from nurses is associated with better family functioning of patients with heart failure and their nearest relatives and to examine whether family health mediates this relationship

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