title: Effects of an exercise intervention for older heart failure patients on caregiver burden and emotional distress.
abstract: BACKGROUND
  The impact of exercise programmes for heart failure on those close to the patient is largely unknown. We examined the effect of a hospital and home-based exercise intervention on burden, anxiety and depression of informal caregivers.
  
  
  METHODS
  The study was a randomized, controlled trial. Heart failure patients were randomized to a seated 12-week hospital-based exercise programme. Caregiver measures were gathered at baseline, 3 months later and 6 months following baseline.
  
  
  METHODS
  Sixty caregivers (mean age 63.4 years, 65% female) of heart failure patients (n = 82, mean age 80.5 years, 44% female) participating in a trial of an exercise intervention were recruited. Caregiver burden, anxiety and depression were assessed.
  
  
  RESULTS
  There were no differences in caregiver burden, depression or anxiety between the two groups of caregivers at baseline (caregiver burden, patient control 33.1 versus patient exercise 34.1; anxiety 4.1 versus 5.5; depression 2.8 versus 3.8). At 3 months there were no differences between caregivers in the two groups on outcomes. At 6-month follow-up caregivers of heart failure patients in the exercise group had burden scores that were significantly worse than the control group. There were no differences between the carers of exercise and control groups in anxiety and depression. Levels of anxiety and depression in the entire carer sample were marginally higher than reference values in a healthy non-clinical sample.
  
  
  CONCLUSIONS
  The present exercise interventions for frail older patients did not benefit caregivers and was associated with an increase in caregiver burden. We suggest that future exercise interventions for heart failure patients should actively incorporate informal caregivers into research designs.
authors.affiliation: School of Psychology, University of Aberdeen, Aberdeen, Scotland, UK. g.molloy@abdn.ac.uk
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Molloy
authors.forename: Derek W
authors.initials: DW
authors.lastname: Johnston
authors.forename: Chuan
authors.initials: C
authors.lastname: Gao
authors.forename: Miles D
authors.initials: MD
authors.lastname: Witham
authors.forename: Joan M
authors.initials: JM
authors.lastname: Gray
authors.forename: Ishbel S
authors.initials: IS
authors.lastname: Argo
authors.forename: Allan D
authors.initials: AD
authors.lastname: Struthers
authors.forename: Marion E T
authors.initials: ME
authors.lastname: McMurdo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001007:Anxiety; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003863:Depression; D004644:Emotions; D005081:Exercise Therapy / Q000009:adverse effects*; D005260:Female; D006333:Heart Failure / Q000534:rehabilitation*; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological