Older Adults With Cardiovascular Disease and Their Care Partners: An Analysis of Care Needs, Care Activities, and Care Partner Stress and Mental Health

患有心血管疾病的老年人及其照护者:照护需求、照护活动以及照护者压力和心理健康分析

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Abstract

BACKGROUND: Comparatively less research has been done on caregiving for persons with cardiovascular disease (CVD) than in other chronic conditions, leaving gaps in guidance for clinical care and interventions. OBJECTIVE: We aimed to describe the care needs of older adults with CVD in the United States and identify determinants of stress and mental health in their care partners. METHODS: This was a cross-sectional analysis using the National Health and Aging Trends Study (n = 1011 persons with CVD) and the National Study of Caregiving (n = 510 CVD care partners). We compared differences in health and care needs of persons with and without CVD and described care partners' caregiving activities. Using multivariate regression, we examined determinants of care partner stress and anxiety/depression. RESULTS: Persons with CVD had higher comorbid burden, worse health, and more care needs than those without CVD. Most care partners helped with activities of daily living in addition to disease-related care. Worse stress was associated with worse care partner health ( β  = 0.357; 95% confidence interval [CI], 0.192-0.522), more care activities ( β  = 0.388; CI, 0.070-0.705), greater care coordination ( β  = 0.367; CI, 0.012-0.722), more medical/nursing tasks ( β  = 0.489; CI, 0.145-0.834), and poorer relationship quality with the care recipient ( β  = -0.269; CI, -0.365 to -0.173). Care partners were more likely to have anxiety/depression if their care recipient had poorer mental health (odds ratio [OR], 1.137; CI, 1.017-1.270), whereas better relationship quality and higher educational attainment appeared protective (OR, 0.837 [CI, 0.719-0.975], and OR, 0.170 [CI, 0.076-0.380], respectively). CONCLUSIONS: Our findings suggest a need for broader examination of caregiving burden in CVD, well beyond CVD-specific aspects.

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