Caregiver Strain and Heart Failure Patient Clinical Event Risk: An Extension of Previous Work

Julie T. Bidwell, Christopher S. Lee, Melinda K. Higgins, Carolyn M. Reilly, Patricia C. Clark, Sandra B. Dunbar

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background In a study of Italian heart failure patient-caregiver dyads, greater caregiver strain significantly predicted lower patient clinical event risk. Objective The purpose of this secondary analysis was to examine this relationship in a sample from the United States. Methods Data came from 92 dyads who participated in a self-care intervention. Logistic regression was used to test the relationship between baseline strain (Bakas Caregiving Outcomes Scale, divided into tertiles) and patient likelihood of events (heart failure hospitalization/emergency visit or all-cause mortality) over 8 months. Results Nearly half of patients (n = 40, 43.5%) had an event. High (vs low) caregiver strain was associated with a 92.7% event-risk reduction, but with substantial variability around the effect (odds ratio, 0.07; 95% confidence interval, 0.01-0.63; P =.02). Conclusions Although findings were similar to the Italian study, the high degree of variability and contrasting findings to other studies signal a level of complexity that warrants further investigation.

Original languageEnglish (US)
Pages (from-to)262-267
Number of pages6
JournalJournal of Cardiovascular Nursing
Issue number3
StatePublished - May 1 2020


  • caregiver strain/burden
  • caregivers
  • heart failure
  • hospitalization
  • mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing


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