Heart Failure Family Caregiver Sleep Quality and Physical, Psychological, and Physiologic Outcomes Open Access

Otuguor, Udia-Oghenetega (Fall 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/zp38wd75s?locale=en


Background: Over the next 20 years, the United States will experience an increase in the number of people with chronic diseases as the baby boomer's population ages. As the number of people living with chronic conditions grows, the demand for family caregivers is also expected to grow. Heart failure is a chronic condition and remains the number one cause of hospitalization of elders in the United States. With hospital stays becoming shorter, family members are expected to provide continued care and manage their loved one's heart failure after initial hospital discharge, at home. Family caregiving is demanding, stressful and family caregivers often report poor sleep quality, which is detrimental to their overall health and well-being; yet, little is known about the sleep health of the family caregiver of persons with heart failure.

 Purpose: The purpose of this dissertation was to examine the prevalence of poor sleep quality and factors associated with poor sleep quality among family caregivers of persons with heart failure.

Sample and Design: This was a descriptive correlational study of 127 family caregivers of persons with heart failure (N=127, Mean age 55.3 ± 1.5 years) using baseline data from a family caregiver interventional study. Variables and measures included sociodemographic characteristics, sleep quality (Pittsburgh Sleep Quality Index), caregiver burden (Oberst Caregiving burden Scale; Bakas Caregiving Outcomes Scale), Anxiety (STAI), depressive symptoms (CES-D), and measures of health status (SF-36, IL-6, salivary cortisol). Analysis included descriptive statistics, correlations, and multiple regression.

Results: About 82% of family caregivers of persons with heart failure report poor sleep. Poor sleep quality was associated with higher caregiving stress factors (p<0.05) but not with family caregiver sociodemographic or comorbidity factors. In addition, an association between poor sleep quality and lower physical function (p=.02), as well as poorer psychological function including higher levels of anxiety (p=.03) and depressive symptoms (p<.01) was observed. No association was observed between poor sleep quality and physiologic outcomes of cortisol and interleukin 6.

Conclusion: The findings of this study suggest that poor sleep quality is prevalent in family caregivers of persons with heart failure, and that family caregivers who experienced poor sleep had worse health outcomes. Caregiver stress factors are possible targets of intervention to reduce caregiver burden and possibly affect sleep quality. Future studies are needed to develop and test interventions that improve family caregivers' health outcomes.

Table of Contents

Chapter I: Introduction                                       1

Figure 1.1 Conceptual framework of sleep quality in Family Caregivers of persons with heart failure 5

Chapter II: Sleep Quality and Associated Factors Among Family Caregivers of persons with Chronic Diseases: A Literature Review 28

Figure 2.1 Flowchart of study literature review 50

Table 2.1 Sleep studies on family caregivers of persons with chronic diseases 51

Table 2.2 Health outcomes associated with family caregivers Sleep 60

Table 2.3 Recommendations for future research                     62

Chapter III: Factors Associated with Sleep Quality in Family Caregivers of Heart Failure Persons 63

Table 3.1 Descriptive statistics of family characteristics and theoretical variables 83

Table 3.2 Relationships among sleep quality, specific sleep characteristics, and caregiving stress factors 85

Table 3.3 Final regression model predicting sleep quality (PSQI) Scores 86

Chapter IV: Heart failure Family Caregiver Sleep Quality, and Physical, Psychological and Physiologic Outcomes 87

Table 4.1 Description of family caregivers demographic and health characteristics             114

Table 4.2 Relationship among independent and outcome variables 116

Table 4.3 Multiple regression analysis of factors that contribute to family caregivers physical function 117

Table 4.4 Relationship between O\overall sleep quality and psychological Function 118

Table 4.5 Relationship between overall sleep quality and psychological function119

Chapter V: Conclusion                                                                             120

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