title: Family member accompaniment to routine medical visits is associated with better self-care in heart failure patients.
abstract: OBJECTIVE
  To examine the association between frequency of family member accompaniment to medical visits and heart failure (HF) self-care maintenance and management and to determine whether associations are mediated through satisfaction with provider communication.
  
  
  METHODS
  Cross-sectional survey of 150 HF patients seen in outpatient clinics. HF self-care maintenance and management were assessed using the Self-Care of Heart Failure Index. Satisfaction with provider communication was assessed using a single question originally included in the American Board of Internal Medicine Patient Satisfaction Questionnaire. Frequency of family member accompaniment to visits was assessed using a single-item question. We performed regression analyses to examine associations between frequency of accompaniment and outcomes. Mediation analysis was conducted using MacKinnon's criteria.
  
  
  RESULTS
  Overall, 61% reported accompaniment by family members to some/most/every visit. Accompaniment to some/most/every visit was associated with higher self-care maintenance (β = 6.4, SE 2.5; p = 0.01) and management (β = 12.7, SE 4.9; p = 0.01) scores. Satisfaction with provider communication may mediate the association between greater frequency of accompaniment to visits and self-care maintenance (1.092; p = 0.06) and self-care management (1.428; p = 0.13).
  
  
  CONCLUSIONS
  Accompaniment to medical visits is associated with better HF self-care maintenance and management, and this effect may be mediated through satisfaction with provider communication.
authors.affiliation: Division of General Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA crystal_cene@med.unc.edu.
authors.forename: Crystal W
authors.initials: CW
authors.lastname: Cené
authors.affiliation: Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Laura Beth
authors.initials: LB
authors.lastname: Haymore
authors.affiliation: NC Translational and Clinical Sciences (TraCS) Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Feng-Chang
authors.initials: FC
authors.lastname: Lin
authors.affiliation: Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Laux
authors.affiliation: Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Christine Delong
authors.initials: CD
authors.lastname: Jones
authors.affiliation: School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Jia-Rong
authors.initials: JR
authors.lastname: Wu
authors.affiliation: Division of General Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Darren
authors.initials: D
authors.lastname: DeWalt
authors.affiliation: Division of General Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Mike
authors.initials: M
authors.lastname: Pignone
authors.affiliation: Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Giselle
authors.initials: G
authors.lastname: Corbie-Smith
mesh_terms: D000368:Aged; D003142:Communication; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D061348:Medical Chaperones; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data*; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: Family; heart failure; patient–provider communication; self-care; social support
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