The Role of Dyadic Confidence on Engagement in Heart Failure Care Behaviors

Background and Objectives: Increasingly, older adults and their families are expected to manage complex conditions with little support. In the case of heart failure (HF), symptom monitoring and management are critical in preventing acute exacerbations and poor clinical outcomes. The current study examined the role of dyadic confdence on engagement in HF care behaviors by patients and their spouses. Research Design and Methods: A cross-sectional design was used to examine 60 couples living with HF. Three dyadic confdence variables were created to represent average level of confdence, gap in confdence, and direction of gap within each couple. A series of multilevel models were used to examine dyadic engagement in HF maintenance, management, and consulting behaviors and the role of dyadic confdence. Results: Patients were signifcantly more engaged in HF maintenance behaviors than spouses; couples were more collaborative in their engagement in HF management and consulting behaviors. Average level of confdence in the dyad was signifcantly associated with patient engagement in all three HF behaviors. Spouse engagement was associated with more congruence in confdence and having higher levels of confdence than their partners with HF. Women were signifcantly more engaged in HF behaviors than men, regardless of role. Discussion and Implications: The study employed a dyadic approach to HF care and a novel approach to confdence. Findings confrm the social nature of confdence and its important role in HF. Clinicians have opportunities to optimize patient outcomes by fostering greater collaboration within couples.