Family members’ or friends’ involvement in self-care for patients with depressive symptoms and co-morbid chronic conditions

Abstract

Objectives

To describe the support that patients reported receiving from family or friends (F/F) while participating in a self-care intervention for depressive symptoms; examine associations between patient-reported F/F support and use of self-care materials; and describe F/F perceptions of involvement in a subsample of F/F.

Methods

One hundred eighty-nine of 223 (85%) patients aged 40+ with chronic physical conditions and co-morbid depressive symptoms participating in a randomized self-care intervention trial, completed structured telephone surveys at three months about the F/F support received. Ten F/F participated in post study qualitative interviews on the support provided.

Results

30%, 44%, and 91% of patients reported overall F/F support with self-care, F/F involvement with the self-care intervention and emotional support, respectively. 61% felt positively and 10% felt negatively or conflicted with F/F support. F/F involvement in the self-care intervention was the only variable associated with patient use of self-care materials when examined alongside all F/F support variables (Proportional Odds Ratio = 1.21; 95% C.I. = 1.01, 1.45). F/F perceived less involvement in the self-care intervention than patients.

Discussion

Patients engaged in a self-care intervention for depressive symptoms use more self-care materials when they perceive F/F involvement in the intervention. Patients and F/F may perceive involvement differently and benefit from discussions about potential F/F roles.

Keywords

Self-care depression family support chronic illnesses adherence

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References

Wagner

Austin

Von Korff

. Organizing care for patients with chronic illness. Milbank Q 1996; 74: 511–544.

Bilsker

Goldner

Anderson

. Supported self-management: a simple, effective way to improve depression care. Can J Psychiatry 2012; 57: 203–209.

Bodenheimer

Lorig

Holman

. Patient self-management of chronic disease in primary care. J Amer Med Assoc 2002; 288: 2469–2475.

Sebern

Woda

. Shared care dyadic intervention: outcome patterns for heart failure care partners. West J Nurs Res 2012; 34: 289–316.

McCusker

Cole

Yaffe

. A feasibility study of a telephone-supported self-care intervention for depression among adults with a co-morbid chronic physical illness in primary care. Ment Health Fam Med 2012; 9: 257–273.

Simco

McCusker

Sewitch

. Adherence to a telephone-supported depression self-care intervention for adults with chronic physical illnesses. SAGE Open 2015; 5: 1–9.

McCusker

Cole

Yaffe

. A randomized trial of a depression self-care toolkit with or without lay telephone coaching for primary care patients with chronic physical conditions. Gen Hosp Psychiatry 2015; 37: 257–265.

Sayers

Riegel

Pawlowski

. Social support and self-care of patients with heart failure. Ann Behav Med 2008; 35: 70–79.

Gleeson-Kreig

Bernal

Woolley

. The role of social support in the self-management of diabetes mellitus among a hispanic population. Publ Health Nurs 2002; 19: 215–222.

10.

Rosland

A-M

Piette

. Emerging models for mobilizing family support for chronic disease management: a structured review. Chron Illn 2010; 6: 7–21.

11.

Toljamo

Hentinen

. Adherence to self-care and social support. J Clin Nurs 2001; 10: 618–627.

12.

Wingham

Harding

Britten

. Heart failure patients’ attitudes, beliefs, expectations and experiences of self-management strategies: a qualitative synthesis. Chron Illn 2014; 10: 135–154.

13.

Cheraghi-Sohi

Jeffries

Stevenson

. The influence of personal communities on the self-management of medication taking: a wider exploration of medicine work. Chron Illn 2015; 11: 77–92.

14.

Smith

. Stigma. Adv Psychiatr Treat 2002; 8: 317–323.

15.

McCusker

Latimer

Cole

. The nature of informal caregiving for medically ill older people with and without depression. Int J Geriatr Psychiatry 2009; 24: 239–246.

16.

van Wijngaarden

Schene

Koeter

MWJ

. Family caregiving in depression: impact on caregivers’ daily life, distress, and help seeking. J Affect Disord 2004; 81: 211–222.

17.

Detweiler-Bedell

Friedman

Leventhal

. Integrating co-morbid depression and chronic physical disease management: identifying and resolving failures in self-regulation. Clin Psychol Rev 2008; 28: 1426–1446.

18.

Bandura

. Social foundations of thought and action: a social cognitive theory, Englewood Cliffs, NJ: Prentice-Hall, Inc., 1986.

19.

Graven

Grant

. Social support and self-care behaviors in individuals with heart failure: an integrative review. Int J Nurs Stud 2014; 51: 320–333.

20.

Stopford

Winkley

Ismail

. Social support and glycemic control in type 2 diabetes: a systematic review of observational studies. Patient Educ Couns 2013; 93: 549–558.

21.

Piette

Aikens

Trivedi

. Depression self-management assistance using automated telephonic assessments and social support. Am J Manag Care 2013; 19: 892–900.

22.

Sussman

Yaffe

McCusker

. A mixed methods exploration of family members’/friends’ roles in a self-care intervention for depression. Chron Illn 2014; 10: 93–106.

23.

Rosland

Heisler

Choi

. Family influences on self-management among functionally independent adults with diabetes or heart failure: do family members hinder as much as they help? Chron Illn 2010; 6: 22–33.

24.

Karlsen

Bru

. The relationship between diabetes-related distress and clinical variables and perceived support among adults with type 2 diabetes: a prospective study. Int J Nurs Stud 2014; 51: 438–447.

25.

Wilkinson

Whitehead

Ritchie

. Factors influencing the ability to self-manage diabetes for adults living with type 1 or 2 diabetes. Int J Nurs Stud 2014; 51: 111–122.

26.

Spitzer

Kroenke

Williams

. Validation and utility of a self-report version of prime-md: the phq primary care study. Primary care evaluation of mental disorders. Patient health questionnaire. J Amer Med Assoc 1999; 282: 1737–1744.

27.

Lowe

Unutzer

Callahan

. Monitoring depression treatment outcomes with the patient health questionnaire-9. Med Care 2004; 42: 1194–1201.

28.

Katzman

Brown

Fuld

. Validation of a short orientation-memory-concentration test of cognitive impairment. Am J Psychiatry 1983; 140: 734–739.

29.

Davous

Lamour

Debrand

. A comparative evaluation of the short orientation memory concentration test of cognitive impairment. J Neurol Neurosurg Psychiatry 1987; 50: 1312–1317.

30.

Statistics Canada; Health Statistics Division, Data Liberation Initiative (Canada), McGill University; Electronic Data Resources Service; et al. Canadian community health survey-cycle 1.2, mental health and well-being (2002). Ottawa, Ontario, Québec: Statistics Canada, Health Statistics Division distributed through Sherlock, Cooperative Data Access System for Quebec University Libraries, 2003, http://sherlock.crepuq.qc.ca/cgi-bin/sherlock.pl?langue=E;action=LAE;region=Canada;region=Autres (accessed 5 February 2016).

31.

Statistics Canada; Health Statistics Division, Data Liberation Initiative (Canada), McGill University; Electronic Data Resources Service; et al. Canadian community health survey-cycle 2.1–2003. Ottawa, Ontario, Québec: Statistics Canada, Health Statistics Division distributed through Sherlock, Cooperative Data Access System for Quebec University Libraries, 2004, http://sherlock.crepuq.qc.ca/cgi-bin/sherlock.pl?langue=E;action=LAE;region=Canada;region=Autres (accessed 5 February 2016).

32.

Ware

Kosinski

Keller

. A 12-item short form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 1996; 34: 220–233.

33.

Kroenke

Spitzer

Williams

JBW

. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16: 606–613.

34.

Khattree

Naik

. Multivariate data reduction and discrimination with SAS software, Cary, NC: SAS Institut Inc., 2000.

35.

Thompson

. Score reliability: contemporary thinking on reliability issues, Thousand Oaks, CA: SAGE Publications, 2003.

36.

Fleiss

Levin

Paik

. Statistical methods for rates and proportions, 3rd ed. Hoboken, NJ: John Wiley & Sons, 1981.

37.

Kutner

Nachtsheim

Neter

. Applied linear regression models, 4th ed. New York: McGraw Hill College, 2003.

38.

Sheskin

. Handbook of parametric and nonparametric statistical procedures, 3rd ed. New York: Chapman and Hall/CRC Press LLC, 2004.

39.

Hosmer

DWJ

Lemeshow

. Applied logistic regression, New York: John Wiley & Sons, Inc., 1989.

40.

Braun

Clarke

. Using thematic analysis in psychology. Qual Res Psychol 2006; 3: 77–101.

41.

Strauss

Corbin

. Basics of qualitative research: techniques and procedures for developing grounded theory, 2nd ed. London: SAGE Publications, 1998.

42.

Janevic

Rosland

Wiitala

. Providing support to relatives and friends managing both chronic physical illness and depression: the views of a national sample of U.S. Adults. Patient Educ Couns 2012; 89: 191–198.

43.

August

Rook

Franks

. Spouses’ involvement in their partners’ diabetes management: associations with spouse stress and perceived marital quality. J Fam Psychol 2013; 27: 712–721.

44.

Fisher

. Research on the family and chronic disease among adults: major trends and directions. Fam Syst Health 2006; 24: 373–380.

45.

Fava

Ruini

Rafanelli

. Six-year outcome of cognitive behavior therapy for prevention of recurrent depression. Am J Psychiatry 2004; 161: 1872–1876.

46.

Britt

Hudson

Blampied

. Motivational interviewing in health settings: a review. Patient Educ Couns 2004; 53: 147–155.

47.

Clark

Freydberg

McAlister

. Patient and informal caregivers’ knowledge of heart failure: necessary but insufficient for effective self-care. Eur J Heart Fail 2009; 11: 617–621.

48.

Wolff

Roter

Barron

. A tool to strengthen the older patient-companion partnership in primary care: results from a pilot study. J Am Geriatr Soc 2014; 62: 312–319.