How deep is your involvement? Caregiver Contribution to self-care in heart failure: A content qualitative analysis with magnitude coding

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction People with heart failure (HF) often rely on the support of informal caregivers to perform self-care. While caregiver contributions (CC) to HF self-care have been described, little is kwon how deeply caregivers are involved in supporting HF patient to perform self-care. Purpose This study aimed to describe with which actions informal caregivers contributed to the self-care of people with HF and with what intensity these actions are acted upon. Method We used a qualitative-descriptive design. We enrolled a convenience sample of HF caregivers who were aged > 18 and cared for their patients for at least six months. Interviews were conducted from August 2020 to February 2021, via telephone. All interviews were recorded, transcribed verbatim and analysed using content analysis with a deductive and inductive approach. Two investigators independently performed a two-round coding of the transcriptions using NVIVO: firstly, we used "Verbal Exchange coding", to identify the verbs of the actions performed by caregivers; secondly, we used "Magnitude Coding" to qualify the intensity caregiver involvement in HF care from M1 = low level of contribution (i.e., passive occasionally observation), to M2 = medium level of contribution (i.e., active regularly observation and contribution) and M3 = high level of contribution (i.e., daily contribution as recommended by guidelines). Categories, sub-categories, and codes were grouped in the three theoretical dimensions of CC to self-care maintenance, self-care monitoring and self-care management. Results The mean age of the 22 enrolled caregivers was 53.45 years (range 30-78). Most of the participants were female (n=17), married (n=11) adult children (n=14) and in cohabitation with the patients (n=13) caring for them for an average of 9.32 hours per day (range 2-24 hours/day). 32 different actions were identified as played by caregivers: 9 in self-care maintenance, 14 in self-care monitoring, and 9 in self-care management. Among the 9 self-care maintenance actions, the contribution in M1 was "Physical activity" which was coded 1 time; the action in M3 was "Ensuring that the person consumes low-salt foods" coded 12 times. Among the 14 self-care monitoring actions, the contribution in M1 was "Noting health changes", coded 11 times, while the contribution in M3 was "Understanding the origin of symptoms" coded 20 times. with (M3). Among self-care management actions, the contribution in M1 was "Seeking advice from family or friends about symptom management", coded 4 times; the highest contribution with M3 was "Knowing how to manage decompensation flare-ups" which was coded 13 times. Conclusion(s): How caregivers are involved in the process of their contribution to HF self-care is important to tailor future interventions.