ABSTRACT
Objective·To explore the impact and mechanism of disease management of caregivers on self-management behaviors among patients with chronic heart failure.Methods·A total of 231 dyads of outpatient chronic heart failure patients and their caregivers were assessed by caregivers contribution to self-care of heart failure index (CC-SCHFI),self-care of heart failure index (SCHFI) and Atlanta heart failure knowledge test (AHFKT-V2).IBM SPSS 22.0 was used to conduct the paired t test and Pearson correlation analysis.LISREL 8.80 was used to conduct the path analysis.Results·There were significant differences between caregivers and patients in maintenance behavior (P=0.015),management behavior (P=0.023) and self-efficacy (P=0.001).There was no correlation between caregiver self-efficacy and patient heart failure knowledge and skill,but other variables were positively correlated,and r value ranged from 0.129 to 0.575 (P＜0.05).Patient self-management behaviors were directly influenced by caregiver disease management,patient heart failure knowledge and skill and patient self-efficacy,and indirectly influenced in part by caregiver disease management through patient heart failure knowledge and skill and patient self-efficacy.Conclusion·Caregiver disease management not only can directly influence patient self-management behaviors,but also can indirectly influence patient self-management behaviors through patient heart failure knowledge and skill and self-efficacy.Health care workers should carry out family-centered health education,and help caregivers actively participate in disease management of patients with heart failure;for those patients whose caregivers can't change their disease management behaviors,health care workers should also improve their self-management behaviors by improving paticnts' heart failure knowledge and skill and self-efficacy.