JMIR Publications

ABSTRACT

Background:

The population of patients with heart failure (HF) is rapidly aging, and the prevalence of HF continues to rise among older adults. Effective HF self-care is essential for improving survival and reducing hospital readmissions, and the role of family caregivers in supporting and reinforcing these behaviors has become increasingly important. With the growing integration of digital health technologies into HF management, technology-assisted self-care is becoming more common. However, many older adults experience difficulties in adopting and effectively using digital tools, which may limit the potential benefits of digital health interventions. As both patients’ and caregivers’ levels of digital literacy may jointly shape HF self-care behaviors, a dyadic analytic approach is warranted to clarify their interdependent effects.

Objective:

This study aimed to compare digital literacy between older patients with HF and their caregivers and to examine how digital literacy influences HF self-care behaviors within patients-caregiver dyads.

Methods:

This cross-sectional study included 102 HF patient-caregiver dyads recruited from outpatient clinics in South Korea. Digital literacy was measured using the Everyday Digital Literacy Questionnaire (EDLQ), HF self-care was assessed using the Self-care of Heart Failure Index (SCHFI-V7.2) for patients and the Caregiver Contribution to Self-care of Heart Failure Index (CCSCHFI-V2) for caregivers. Dyadic associations were analyzed using the Actor-Partner Interdependence Model (APIM).

Results:

Patients (mean age =79.44 years, NYHA class Ⅱ 51.0%) had significantly lower digital literacy than caregivers (mean age=58.97 years, 32.4% were spousal relationship). Patient’s digital literacy had an actor effect on symptom perception (B = .499, p < .001) and management (B = .466, p=.003) of HF self-care. Caregiver’s digital literacy affected their contribution to symptom perception (B = .287, p = .014). However, no partner effect was observed.

Conclusions:

Digital literacy significantly influenced individuals’ own HF self-care behaviors (actor effects) but not their partner's outcomes. To optimize digital health strategies for HF self-care, digital interventions should assess and address the digital skills of both patients and caregivers.