P006. Relationship of Heart Failure Patient Caregivers Mutuality and Preparedness to Caregiving Role Strain and Burden during COVID-19

Abstract

<h3>Background</h3> The hospitalization rates among Heart Failure (HF) patients has increased from 23% in 2000 to 29% in 2010 necessitating the efforts to improve care and reduce cost (CDC, 2014). This is causing an increase burden on the health care system, families, and the society. At discharge, patients are educated on self-care, which is a non-pharmacological approach towards patients managing their own disease state. Self-care is a difficult concept for most Heart Failure patients to master because it requires adapting to new life-style changes. The caring burden increases as patient's advance in the disease state. HF patients rely on informal care givers who are family and friends (Hooker, Schmiege, Trivedi, Amoyal & Beleman, 2019). The sudden transition to the Heart failure patient's caregiver role can be a social, financial, emotional, and physical strain that effects effective role adaptation. It is important to consider mutuality and preparedness when preparing care givers to their new role. Caregiver mutuality and preparedness can have mediating effects on caregiver role strain and burden over time (Schumacher, Stewart, & Archbold, 2007). <h3>Methods</h3> The purpose of this cross-sectional correlational study was to investigate the relationship between Heart failure patient's caregiver mutuality and preparedness for caregiving to role strain and burden. Two hypotheses were tested in this study: 1) There will be a negative relationship between Heart failure patient's caregiver mutuality and preparedness to caregivers role strain and burden 2) There will be a negative relationship between mutuality and preparedness to caregivers role strain and burden. The Roy Adaptation Model guided this research. The sample consisted of 195 adult Heart failure patient caregivers who participated via Amazon Mechanical Turk (M Turk) a crowd sourcing marketplace for survey participation and data collection. Predictor measures included mutuality and preparedness. Mutuality was measured by the Mutuality Scale and preparedness was measured by the Preparedness for Caregiving Scale. The outcome measure, role strain, was measured by the caregiver's perception of financial, physical, and social strain, and burden was measured with the Zarit burden scale. <h3>Results</h3> This study demonstrated that there was a statistically significant negative relationship between caregiver mutuality and preparedness to role strain, r (195) =.058, <i>p</i> < .001 and a statistically significant negative relationship between caregiver mutuality and preparedness to burden, r(195) =.071, <i>p</i> < .001. These findings indicate that mutuality and preparedness are important predictors of caregiver role strain and burden. The Heart failure certified nurse is positioned to translate the evidence of caregiver role research to the assessment, planning, and evaluation of interventions that can assist the informal caregiver during the dynamic phases of caregiver role adaptation. <h3>Conclusion</h3> Assessing the caregiver's preparation for caregiving, in addition to caregiver mutuality, is an important step in individualizing interventions that will have a positive effect on the role transition to caregiver. Furthermore, individual interventions based on the demand of caregiving will assist in the preparation of the caregiver during the transition to the community setting. This output includes descriptive on the variables, custom tables that display the set of responses for each of your composite variables and a few regressions to explore your states hypotheses. •Regression (multivariate): Mutuality and Preparedness vs Strain ○ R2=.058 (low) and p=.001 (signif) ○ Coefficients: ▪ Mutuality: -.216 (p=.042) — a negative impact (decreases) on strain (not much, but significant) ▪ Preparedness: .435 (p=.000) – a positive impact (increases) on strain •Regression (bivariate): <b>Preparedness vs Strain</b> ○ R2=.042 (low) and p=.002 (signif) ○ Coefficient: .275 (p=.002) – a positive impact (increases) on strain •Regression (bivariate): <b>Mutuality vs Strain</b> ○ R2=-.004, p=.600 <b>NOTE:</b> Mutuality not statistically significant on its own. Interplay with Preparedness •Regression (bivariate): <b>Mutuality and Preparedness vs Burden</b> ○ R2=.071 (low), p=.001 (signif) ○ Coefficients: ▪ Mutuality: -.427 (p=.000) – negative impact (decreases) perceived Burden ▪ Preparedness: .475 (p=.000) – positive impact (increases) perceived Burden ○ Regression: Mutuality vs Burden – NOT SIGNIFICANT ○ Regression: Preparedness vs Burden –NOT SIGNIFICANT •Regression: <b>Burden vs Strain</b> ○ R2=.312 (stronger impact than those above), p=.000 (signif) ○ Coefficient for Burden = .515 (p=.000) (For each one point increase in the Burden score, there is a half point increase in the Strain score. Remember that these scores only range from 0 to 4, so this is a heavy hit