Background:
Research points to reciprocal influences that patients and partners may have on one another’s recovery in cardiac illness, yet interventions to enhance recovery after an implantable cardioverter defibrillator (ICD) are usually directed only toward the patient.
Purpose:
To compare 2 social cognitive (SC) intervention conditions (patient only or P-only, and patient + partner or P+P) from the Patient + Partner RCT. Patient physical symptoms and depression were compared
with
partner caregiver burden over 12 months post initial ICD.
Methods:
The study included 301 patient-partner dyads (151=P-only; 150=P+P) who participated in 1 of 2 nurse-led SC interventions delivered by telephone in the first 3 months after the patient received an ICD. Patient symptoms were measured with the PCA, depression with the PHQ-9, and partner caregiver burden with the OCBS, at baseline, 3, 6, and 12 months. Parallel process growth modeling and mixed effects models were used to compare intervention outcomes.
Results:
Patients were on average 64±12 years old, male (74%), white (91%), and most received an ICD for primary prevention (60%). Partners were on average 62±12 years, female (74%), and white (88%). In the first 3 months, decline in patient depression was significantly associated with decline in partner caregiver burden in P+P (β=0.93; p<0.001), but
not
in P-only (β= -0.14; p=0.54). Decline in physical symptoms was more strongly associated with decline in partner caregiver burden in P+P (β=0.93, p<0.001) than P-only (β=0.58, p=0.02). At 3 months, there were no significant differences in patient physical (p=0.59) and depressive symptoms (p=0.27) for P+P vs P-only. Partner caregiver burden was significantly lower in P+P vs P-only (p=0.01). At 12 months, patient physical and depressive symptoms and partner caregiver burden were significantly lower in P+P vs P-only (p=0.043, p=0.008, p=0.001, respectively).
Conclusion:
A SC intervention that included intimate partners (P+P) showed greater reductions in patient physical and depressive symptoms and partner caregiver burden and reflected greater reciprocal influence than the P-only intervention. Dyadic SC interventions can provide added support for patients after an ICD and may improve partner caregiver burden.
Reciprocal influences between parenting and adolescent problem-solving behavior.