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Bouldin ED, Aikens JE, Piette JD, Trivedi RB. Relationship and communication characteristics associated with agreement between heart failure patients and their Carepartners on patient depressive symptoms. Aging & mental health. 2019 Sep 1; 23(9):1122-1129.
Informal caregivers who recognize patients' depressive symptoms can better support self-care and encourage patients to seek treatment. We examined patient-caregiver agreement among patients with heart failure (HF). Our objectives were to (1) identify distinct groups of HF patients and their out-of-home informal caregivers (CarePartners) based on their relationship and communication characteristics, and (2) compare how these groups agree on the patients' depressive symptoms. We used baseline data from a comparative effectiveness trial of a self-care support program for veterans with HF treated in outpatient clinics from 2009-2012. We used a cross-sectional design and latent class analysis (LCA) approach to identify distinct groups of patient-CarePartner dyads (n? = 201) based on relationship and communication characteristics then evaluated agreement on patients' depressive symptoms within these groups. The LCA analysis identified four groups: (n? = 102 dyads, 51%), (n? = 33 dyads, 16%), (n? = 35 dyads, 17%), and (n? = 31 dyads, 15%). Dyadic agreement on the patients' depressive symptoms was highest in the (Kappa (?)? = 0.44, r? = 0.39) and groups (?? = 0.19, r? = 0.32), and relatively poor in the (?? = -0.20, r? = 0.17) and (?? = -0.01, r? = 0.004) groups. Patients in (61%) and groups (74%) more frequently had depression based on self-report than patients in (46%) and (34%) groups. Caregiver relationships in HF tend to be either , , , or Patients' depressive symptoms may negatively affect how they communicate with their caregivers. At the same time, improved patient-caregiver communication could enhance dyadic consensus about the patient's depressive symptoms.