Abstract 13330: Sociodemographic and Clinical Determinants of Self-Care and Caregiver Contribution to Self-Care in a Context of Multiple Chronic Conditions
Multiple Chronic Conditions (MCC) are highly prevalent worldwide, especially in cardiac populations. Patients and caregivers contribute to MCC self-care, the process of maintaining illness stability and managing symptoms. The determinants of self-care remain unknown in the MCC population. Our aim was to identify sociodemographic and clinical determinants of patient and caregiver contributions to self-care in MCC.
This was a multicenter observational study in which self-care and caregiver contributions to self-care were measured in 340 dyads (patients and their caregivers) recruited from outpatient and community settings in Italy. Patients were enrolled if: ≥65 years, had heart failure, diabetes or chronic obstructive pulmonary disease and one more chronic condition, and had an informal caregiver >18 years old. Patients with dementia or cancer were excluded. Self-care was measured with the Self-care of Chronic Illness Inventory and the Caregiver Contribution to Self-care of Chronic Illness Inventory. Both psychometrically sound instruments measure self-care maintenance, monitoring, and management. Multilevel Modeling Analysis was used to identify the determinants and to control for interdependence of the dyadic data.
Most (54.1%) patients (mean age 76.65, SD 7.27 years) and most (72.1%) caregivers (mean age 54.32, SD 15.25 years) were female. More than one third (34.15%) of patients had heart failure. Self-care was inadequate in maintenance (65.90, SD 19,67) and management (66.39, SD 18.02). Caregiver contributions were inadequate only in monitoring (57.76, SD 13.55). Patient determinants of better self-care were older age, female gender, higher income, and higher number of medications, while cognitive impairment and diabetes predicted worse self-care. Determinants of better caregiver contributions were female gender, more caregiving hours per week and more caregiver strain, while presence of a secondary caregiver predicted worse contributions to patient self-care.
In the context of MCC, gender influenced self-care for both patients and caregivers. In patients, illness characteristics are important and in caregivers, caregiving responsibilities influence their contributions