Symptom Management and Caregiver Challenges of Informal Caregiving for Older People With Heart Failure: A Mixed Methods Study.

BACKGROUND

Heart failure, characterized by its unpredictable trajectory and challenging symptom management, necessitates continual adaptation and the active involvement of patients and their families.

OBJECTIVE

Heart failure is a growing health challenge in aging societies. Informal caregivers are often the first to observe and respond to symptoms, yet their voices remain underrepresented in the literature. In this study, our aim was to explore how caregivers recognize and manage symptoms in older adults with heart failure and to identify the support they require to sustain this vital role.

METHODS

A sequential, explanatory, mixed methods study was performed. This mixed methods study was reported in accordance with the Good Reporting of A Mixed Methods Study (GRAMMS) checklist. Quantitative data were gathered from 205 caregivers through structured symptom assessments, while qualitative insights were obtained via in-depth interviews with 16 caregivers.

RESULTS

The most frequently observed symptoms included fatigue, dyspnea, and edema. Caregivers described relying on visual cues rather than patient-reported symptoms, often due to limited clinical knowledge or support. Thematic analysis revealed significant emotional strain, physical fatigue, and informational gaps. Many caregivers highlighted the need for practical training, emotional support, and accessible guidance from healthcare professionals.

CONCLUSIONS

Caregivers are not only essential partners in heart failure management-they are often the bridge between the home and healthcare system. Addressing their educational and psychosocial needs through structured training and remote nursing support is critical to improving care continuity and outcomes.