Yingtong Meng, Tingting Zhang, Siyu Lu, Yan Zhang, Yunwen Mao, Xiaohua Ge
{"title":"慢性心力衰竭患者及照护者的家庭复原力和相互关系对自我照护的双重影响：行动者-伴侣相互依存中介模型。","authors":"Yingtong Meng, Tingting Zhang, Siyu Lu, Yan Zhang, Yunwen Mao, Xiaohua Ge","doi":"10.1093/eurjcn/zvaf027","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Self-care and caregivers' contribution to self-care are vital for chronic heart failure (CHF) patients. Family resilience and mutuality are known protective factors for self-care. However, little is known about how family resilience and mutuality contribute to self-care among heart failure patient-caregiver dyads. This study aims to examine actor and partner effects of family resilience on self-care through mutuality among CHF patients and caregiver dyads.</p><p><strong>Methods and results: </strong>In the cross-sectional study, 220 CHF patient-caregiver dyads (n = 440 participants) were enrolled. Family resilience, mutuality, self-care, and self-care contribution to CHF were assessed by self-report questionnaires. The Actor-Partner Interdependence Mediation Model analysis was used to identify the direct and indirect effects of family resilience on self-care through mutuality in CHF patient-caregiver dyads. Actor effects showed that caregivers' family resilience had a direct effect on their own self-care contribution [direct actor effect, B = 0.385; 95% confidence interval (CI), 0.263-0.506]. Caregivers' mutuality (indirect actor effect, B = 0.057; 95% CI, 0.004-0.111) and CHF patients' mutuality (indirect actor effect, B = 0.04; 95% CI, 0.010-0.103) mediated caregivers' family resilience and self-care contribution. Partner effect showed that caregivers' family resilience predicted CHF patients' self-care behaviour (direct partner effect, B = -0.334; 95% CI, -0.406 to -0.251). Chronic heart failure patients' family resilience had indirect effects on caregivers' contribution to self-care via patients' mutuality (indirect partner effect, B = 0.019; 95% CI, 0.001-0.066) and caregivers' mutuality (indirect partner effect, B = 0.025, 95% CI, 0.001-0.058).</p><p><strong>Conclusion: </strong>The results demonstrated a reciprocal influence on self-care between CHF patients and their caregivers. Family resilience within these dyads has impacted not only their own self-care but also those of their caregivers, with mutuality playing a mediating role. These results provided empirical support for improving the patients' self-care behaviour and caregivers' contribution at the dyadic level.</p><p><strong>Registration: </strong>Chinese Clinical Trial Registry: ChiCTR2200064561.</p>","PeriodicalId":93997,"journal":{"name":"European journal of cardiovascular nursing","volume":" ","pages":"618-628"},"PeriodicalIF":0.0000,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Dyadic effects of family resilience and mutuality on self-care in chronic heart failure patients and caregivers: an Actor-Partner Interdependence Mediation Model.\",\"authors\":\"Yingtong Meng, Tingting Zhang, Siyu Lu, Yan Zhang, Yunwen Mao, Xiaohua Ge\",\"doi\":\"10.1093/eurjcn/zvaf027\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>Self-care and caregivers' contribution to self-care are vital for chronic heart failure (CHF) patients. Family resilience and mutuality are known protective factors for self-care. However, little is known about how family resilience and mutuality contribute to self-care among heart failure patient-caregiver dyads. This study aims to examine actor and partner effects of family resilience on self-care through mutuality among CHF patients and caregiver dyads.</p><p><strong>Methods and results: </strong>In the cross-sectional study, 220 CHF patient-caregiver dyads (n = 440 participants) were enrolled. Family resilience, mutuality, self-care, and self-care contribution to CHF were assessed by self-report questionnaires. The Actor-Partner Interdependence Mediation Model analysis was used to identify the direct and indirect effects of family resilience on self-care through mutuality in CHF patient-caregiver dyads. Actor effects showed that caregivers' family resilience had a direct effect on their own self-care contribution [direct actor effect, B = 0.385; 95% confidence interval (CI), 0.263-0.506]. Caregivers' mutuality (indirect actor effect, B = 0.057; 95% CI, 0.004-0.111) and CHF patients' mutuality (indirect actor effect, B = 0.04; 95% CI, 0.010-0.103) mediated caregivers' family resilience and self-care contribution. Partner effect showed that caregivers' family resilience predicted CHF patients' self-care behaviour (direct partner effect, B = -0.334; 95% CI, -0.406 to -0.251). Chronic heart failure patients' family resilience had indirect effects on caregivers' contribution to self-care via patients' mutuality (indirect partner effect, B = 0.019; 95% CI, 0.001-0.066) and caregivers' mutuality (indirect partner effect, B = 0.025, 95% CI, 0.001-0.058).</p><p><strong>Conclusion: </strong>The results demonstrated a reciprocal influence on self-care between CHF patients and their caregivers. Family resilience within these dyads has impacted not only their own self-care but also those of their caregivers, with mutuality playing a mediating role. These results provided empirical support for improving the patients' self-care behaviour and caregivers' contribution at the dyadic level.</p><p><strong>Registration: </strong>Chinese Clinical Trial Registry: ChiCTR2200064561.</p>\",\"PeriodicalId\":93997,\"journal\":{\"name\":\"European journal of cardiovascular nursing\",\"volume\":\" \",\"pages\":\"618-628\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-05-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European journal of cardiovascular nursing\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/eurjcn/zvaf027\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of cardiovascular nursing","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/eurjcn/zvaf027","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Dyadic effects of family resilience and mutuality on self-care in chronic heart failure patients and caregivers: an Actor-Partner Interdependence Mediation Model.
Aims: Self-care and caregivers' contribution to self-care are vital for chronic heart failure (CHF) patients. Family resilience and mutuality are known protective factors for self-care. However, little is known about how family resilience and mutuality contribute to self-care among heart failure patient-caregiver dyads. This study aims to examine actor and partner effects of family resilience on self-care through mutuality among CHF patients and caregiver dyads.
Methods and results: In the cross-sectional study, 220 CHF patient-caregiver dyads (n = 440 participants) were enrolled. Family resilience, mutuality, self-care, and self-care contribution to CHF were assessed by self-report questionnaires. The Actor-Partner Interdependence Mediation Model analysis was used to identify the direct and indirect effects of family resilience on self-care through mutuality in CHF patient-caregiver dyads. Actor effects showed that caregivers' family resilience had a direct effect on their own self-care contribution [direct actor effect, B = 0.385; 95% confidence interval (CI), 0.263-0.506]. Caregivers' mutuality (indirect actor effect, B = 0.057; 95% CI, 0.004-0.111) and CHF patients' mutuality (indirect actor effect, B = 0.04; 95% CI, 0.010-0.103) mediated caregivers' family resilience and self-care contribution. Partner effect showed that caregivers' family resilience predicted CHF patients' self-care behaviour (direct partner effect, B = -0.334; 95% CI, -0.406 to -0.251). Chronic heart failure patients' family resilience had indirect effects on caregivers' contribution to self-care via patients' mutuality (indirect partner effect, B = 0.019; 95% CI, 0.001-0.066) and caregivers' mutuality (indirect partner effect, B = 0.025, 95% CI, 0.001-0.058).
Conclusion: The results demonstrated a reciprocal influence on self-care between CHF patients and their caregivers. Family resilience within these dyads has impacted not only their own self-care but also those of their caregivers, with mutuality playing a mediating role. These results provided empirical support for improving the patients' self-care behaviour and caregivers' contribution at the dyadic level.
Registration: Chinese Clinical Trial Registry: ChiCTR2200064561.
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