title: Can we engage caregiver spouses of patients with heart failure with a low-intensity, symptom-guided intervention?
abstract: OBJECTIVE
  Evaluate a pilot intervention to engage caregivers in management of heart failure (HF) patient symptoms.
  
  
  BACKGROUND
  HF impairs quality of life; caregivers provide an important role in HF management.
  
  
  METHODS
  We developed modules to help patients report and caregivers alleviate symptoms of depression, pain, dyspnea, and fatigue. Semi-structured interviews followed by a mixed inductive and deductive, team-based analysis were used to evaluate acceptability and feasibility in patients with HF and their caregivers.
  
  
  RESULTS
  Participants (n = 22) expressed significant interest but few used the modules in follow-up. We identified three barriers to acceptability and feasibility: the quality of dyadic relationship, the timing and structure of the intervention, and the patient's perceived control over their illness.
  
  
  CONCLUSIONS
  Future interventions should evaluate dyadic relationship dynamics, match the timing and content of the intervention to the patient population, and enroll patients with perceived control over their illness to maximize intervention acceptability and feasibility.
authors.affiliation: Department of Medicine, Denver VA Medical Center, Denver, CO, USA; Division of General Internal Medicine, Department of Medicine, University of Colorado Denver School of Medicine at the Anschutz Medical Campus, Aurora, CO, USA. Electronic address: Robert.Burke5@va.gov.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Burke
authors.affiliation: Department of Medicine, Denver VA Medical Center, Denver, CO, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Johnson-Koenke
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Colorado Denver School of Medicine at the Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Nowels
authors.affiliation: Center for Clinical Management Research, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, MI, USA; Division of General Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Silveira
authors.affiliation: College of Nursing, University of Colorado, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Jones
authors.affiliation: Department of Medicine, Denver VA Medical Center, Denver, CO, USA; Division of General Internal Medicine, Department of Medicine, University of Colorado Denver School of Medicine at the Anschutz Medical Campus, Aurora, CO, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Bekelman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003863:Depression / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D018454:Spouses
keywords: Caregiver; Heart failure; Palliative care; Quality of life; Symptom management