title: An integrated review of interventions to improve psychological outcomes in caregivers of patients with heart failure.
abstract: OBJECTIVE
  This article examines interventions aimed at improving psychological outcomes (e.g., caregiver burden, quality of life, anxiety, depression, perceived control, stress mastery, caregiver confidence and preparedness, and caregiver mastery) in family caregivers of patients with heart failure.
  
  
  RESULTS
  Eight studies meeting the inclusion criteria were included in the review. The most common intervention involved psychoeducation facilitated by a nurse (6/8) and supplemented with a combination of follow-up face-to-face sessions (2/6), home visits (2/6), telephone calls (3/6), and telemonitoring (3/6). Two studies used a support group intervention of four to six sessions. Half of the interventions reported a significant effect on one or more primary outcomes, including caregiver burden (n = 4), depressive symptoms (n = 1), stress mastery (n = 1), caregiver confidence and preparedness (n = 1), and caregiver mastery (n = 1).
  
  
  CONCLUSIONS
  Compared with dementia and cancer family caregiving, few interventions have been evaluated in caregivers of patients with heart failure. Of the existing interventions identified in this review, considerable variability was observed in aims, intervention content, delivery methods, duration, intensity, methodological rigor, outcomes, and effects. Given this current state of the science, direct comparison of heart failure caregiver interventions and recommendations for clinical practice are premature. Thus, research priority is strongly warranted for intervention development and testing to enhance heart failure caregiver support and education.
authors.affiliation: aUCI Program in Nursing Science, University of California Irvine, Irvine, California bDepartment of Medical and Health Sciences and Department of Cardiology, Linköping University, Linköping, Sweden cSchool of Nursing, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Lorraine S
authors.initials: LS
authors.lastname: Evangelista
authors.forename: Anna
authors.initials: A
authors.lastname: Strömberg
authors.forename: J Nicholas
authors.initials: JN
authors.lastname: Dionne-Odom
mesh_terms: D000223:Adaptation, Psychological; D017028:Caregivers / Q000523:psychology*; D003376:Counseling; D005190:Family; D006266:Health Education / Q000458:organization & administration*; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D008603:Mental Health; D011788:Quality of Life; D013315:Stress, Psychological / Q000523:psychology