BACKGROUND Chronic illness management is increasingly carried out at home by individuals and their informal caregivers (dyads). Although synergistic in concept, the nuances of dyadic congruence in caring for patients with heart failure are largely unexamined. AIMS The purpose of this study was to examine the role of dyadic-type congruence on patient self-care (maintenance, symptom perception, and management) while controlling for actor and partner effects. METHODS This secondary data analysis of 277 dyads consisted of a series of multilevel models to examine the impact of dyadic congruence on a patient's self-care maintenance, symptom perception, and self-care management. Patient-level and caregiver-level data were input into each model simultaneously to account differential appraisals of factors related to the dyad. RESULTS Bivariate analyses yielded dyad congruence which was associated with better patient self-care maintenance, symptom perception and management. However, after multilevel models were constructed, dyad congruence was found to be a significant predictor of patient's symptom perception scores, but not self-care maintenance or management scores. Caregiver's satisfaction with the dyad was differentially and significantly associated with self-care - it was inversely associated with patient self-care maintenance and positively associated with patient self-care management. CONCLUSION This is the first study, to our knowledge, reporting that congruence in heart failure dyads is associated with better patient symptom perception and this advances our prior hypothesis that dyad typologies could be used to predict patient self-care performance. Since symptom perception is the key to preventing heart failure exacerbation, screening heart failure patient and caregiver dyads for congruence is important in clinical settings.

中文翻译：

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对偶一致性和对偶类型满意度对心力衰竭患者自我护理的影响

背景慢性病管理越来越多地由个人和他们的非正式护理人员（二人组）在家中进行。尽管在概念上具有协同作用，但在照顾心力衰竭患者时，二元一致性的细微差别在很大程度上未经检验。目的 本研究的目的是检查二元型一致性对患者自我护理（维护、症状感知和管理）的作用，同时控制参与者和合作伙伴的影响。方法 对 277 个二元组的二次数据分析由一系列多级模型组成，以检查二元组一致性对患者自我护理维护、症状感知和自我护理管理的影响。患者级别和护理人员级别的数据同时输入到每个模型中，以说明对与二元组相关的因素的不同评估。结果 双变量分析得出二元一致性，这与更好的患者自我护理维护、症状感知和管理相关。然而，在构建多层次模型后，发现二元一致性是患者症状感知评分的重要预测因子，但不是自我护理维护或管理评分的重要预测因子。护理人员对二元组的满意度与自我护理存在差异且显着相关 - 它与患者自我护理维持负相关，与患者自我护理管理正相关。结论 据我们所知，这是第一项研究，报告称心力衰竭二元组的一致性与更好的患者症状感知相关，这推进了我们先前的假设，即二元组类型可用于预测患者的自我保健表现。