Improving Benefit and Reducing Burden of Informal Caregiving for Patients With Heart Failure A Mixed Methods Study

Background: Few randomized clinical trials test the effect of interventions on heart failure caregiver well-being. Objective: The aim of this study was to determine the effect of a patient-focused symptom and psychosocial collaborative care intervention (Collaborative Care to Alleviate Symptoms and Adjust to Illness) on heart failure caregiver depression, burden, and benefit-finding. Methods: A sequential explanatory mixed-method design was used in the context of a multisite, randomized clinical trial. Self-reported caregiver depression, burden, and benefit-finding were assessed at baseline and 12 months. Thematic analysis was conducted on social worker documentation of a psychosocial intervention with caregivers. Results: One hundred one caregivers were randomized to usual care or Collaborative Care to Alleviate Symptoms and Adjust to Illness. There were no significant differences in caregiver depression, burden, or benefit-finding between usual care and Collaborative Care to Alleviate Symptoms and Adjust to Illness. Caregiver outcomes were discussed in 42% of intervention notes, highlighting varied and complex caregiver experiences. Inductive analysis reaffirmed the complexity and range of caregiver needs and experiences. Conclusion: A patient symptom/psychosocial intervention did not impact caregiver well-being. Interventions should target specific needs of caregivers.