title: Evaluation of an educational programme for family members of patients living with heart failure: a randomised controlled trial.
abstract: OBJECTIVE
  To evaluate the effect of a group-based multi-professional educational programme for family members of patients with chronic heart failure with regard to quality of life, depression and anxiety. The secondary aim was to investigate the impact of social support and sense of coherence on changes in quality of life, anxiety and depression during the period of the study.
  
  
  BACKGROUND
  When a person is diagnosed with heart failure, the daily life of the family members is also affected.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  A total of 128 family members were randomly assigned to participate in a multi-professional educational programme or a control group. Analysis of variance and regression analysis were used.
  
  
  RESULTS
  There were no significant differences in anxiety, depression or quality of life between the intervention group and control group. Adequacy of social network was the only independent variable that explained levels of anxiety and depression after 12 months beyond baseline levels of anxiety (p < 0·001, R(2) = 0·35) and depression (p = 0·021, R(2) = 0·37). Younger family members were found to have a higher quality of life (p < 0·01).
  
  
  CONCLUSIONS
  Improved disease-related knowledge may need to be combined with other target variables to induce desired effects on depression, anxiety and quality of life of family members. Antecedents of depression and anxiety, such as sense of control, may need to be specifically targeted. Our results also suggest that intervention aimed at enhancing social support may be beneficial for family members.
  
  
  CONCLUSIONS
  Anxiety and depression did not decrease nor did quality of life improve after the intervention. An educational programme for family members with a component specifically targeting anxiety, depression and quality of life warrants testing. Furthermore, it is important that health care providers understand the influence of social support on anxiety, depression and quality of life when interacting with family members.
authors.affiliation: Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine and Sophiahemmet University College, Stockholm, Sweden. caroline.lofvenmark@shh.se
authors.forename: Caroline
authors.initials: C
authors.lastname: Löfvenmark
authors.forename: Fredrik
authors.initials: F
authors.lastname: Saboonchi
authors.forename: Magnus
authors.initials: M
authors.lastname: Edner
authors.forename: Ewa
authors.initials: E
authors.lastname: Billing
authors.forename: Anne-Cathrine
authors.initials: AC
authors.lastname: Mattiasson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D017028:Caregivers / Q000523:psychology*; D003863:Depression; D004505:Education, Nonprofessional / Q000458:organization & administration / Q000592:standards*; D005260:Female; D006333:Heart Failure / Q000451:nursing* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011788:Quality of Life; D012944:Social Support