Acceptability and Usefulness of a Dyadic Problem-Solving Partnership to Promote Rural Heart Failure Self-care

Background: Heart failure (HF) is a common chronic illness in the United States, and rural individuals have a higher risk of this disease, often with negative health outcomes. While dyads cope more effectively in working together to address heart-related problems, there are few innovative studies exploring the acceptability and usefulness of self-care partnership programs to assist rural dyads in managing symptoms and daily challenges. Purpose: We examined the acceptability and usefulness of a telephone problem-solving program with HF dyads for managing HF-related problems in the home. Self-care areas, process outcomes, and underlying structures and patterns regarding acceptability and usefulness were addressed. Methods: Data for this qualitative descriptive study were collected via individual telephone interviews with 29 HF dyads, using an investigator-developed semi-structured interview guide. This analysis focused on the midpoint, in-depth, 5-week analysis of the 12-week parent study to compare early and later data regarding acceptability and usefulness. Adjusted matrix analyses and multiple correspondence analysis were used to address the study aims. Results: Most dyads were completely supportive of the program, and 12 suggested strategies for improving its usefulness. Most dyads focused on self-care maintenance (diet, exercise) problems and self-monitoring (abnormal signs and symptoms). A gender pattern difference was identified in addressing self-care maintenance problems. Conclusion: Our study fills an important gap regarding collaborative transition and empowerment of self-care in rural HF dyads. It also highlights the need for longitudinal research on how gender pattern differences influence self-care in rural dyads.