Abstract
Introduction: Adequate self-care is associated with better health outcomes in those with hypertension (HTN). Interventions including care partners positively affect the health of the person and their partner. Prior dyadic studies report improved self-efficacy and health outcomes in those with chronic illness, but no studies have been done in those with HTN.
Purpose: (1) Examine change in self-care and relationship quality from baseline to one month, and (2) explore role of mental health factors (anxiety and depression) and couple-level characteristics (relationship quality) on self-care health behaviors post intervention.
Theoretical Framework: The Theory of Dyadic Illness Management guided the study.
Methods: Data from 25 dyads was collected during an outpatient cardiology visit. Intervention included baseline education guided by AHA documents, health-promotion goal setting, and three weekly telephone calls for promotion of dyadic interpersonal communication and support for meeting goals. Two health promotion goals related to stress reduction, sleep, physical activity, diet, smoking, and alcohol intake were set by each member of the dyad. Data on demographics, depression (PHQ) anxiety (Beck Anxiety Inventory), relationship quality (Mutuality Scale, 0-100, higher more agreement), and self-care maintenance, monitoring, management, and confidence (SC-HIv3, 0-100, >70 adequate) were collected at baseline and post intervention (one month). Changes in self-care scales and mutuality were examined using paired-sample t-tests. For the second objective, we examined the correlations of baseline depression, anxiety, and mutuality with change scores in self-care scales (Time 2-Time 1).
Results: Sample was 62% female, 65% married; 76% of caregivers were partners and 24% were mother/daughter. Results indicated a significant increase in self-care maintenance (Time 1: M=67.86, SD=18.78; Time 2: M=73.43, SD=12.21) to adequate levels, self-care monitoring (Time 1: M=58.78, SD=29.89; Time 2: M=68.61, SD=26.531), and mutuality (Time 1: M=59.70, SD=16.82; Time 2: M=64.54, SD=12.60). Increased depression and anxiety were significantly related to lower change scores in self-care maintenance and self-care confidence. In addition, higher mutuality scores were related to an increase in confidence scores from Time 2 to Time 2.
Conclusions: A dyadic support intervention was efficacious and improved self-care maintenance, self-care monitoring and mutuality in people with HTN.