Health Psychology Research / HPR / Volume 14 / Issue 1 / DOI: 10.14440/hpr.0448
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REVIEW

Beyond the Heart: Psychological Distress and Caregiver Burden in Heart Failure

Di Wang1 ,  Fengjie Guo2*
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1 Department of Oncology, Loudi Central Hospital, Loudi 417000, China
2 School of Medicine, South China University of Technology, Guangzhou 510006, Guangdong, China
HPR 2026 , 14(1), e81240071; https://doi.org/10.14440/hpr.0448
Submitted: 22 December 2025 | Revised: 10 February 2026 | Accepted: 13 February 2026 | Published: 31 March 2026
© 2026 by the Author(s). Licensee Health Psychology Research, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC BY-NC 4.0) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Background

Heart failure (HF) is a life-limiting syndrome with high morbidity. Although biomedical care has advanced, psychological distress in patients and burden among informal caregivers remain underassessed and undertreated.

Objective

This review synthesizes evidence on: (i) prevalence, predictors, and trajectories of psychological distress in HF; (ii) the scope and determinants of caregiver burden; (iii) adaptive and maladaptive coping strategies; and (iv) implications for integrated clinical care and policy.

Methods

A systematic search of PubMed, Scopus, PsycINFO, and Web of Science was conducted using combined terms for HF, psychological distress, caregiver burden, coping, and quality of life. Data extraction and thematic synthesis aligned with review objectives.

Results

Psychological distress is common in HF. Pooled depression estimates typically range from 20% to 42%, and pooled estimates of anxiety from 15% to 30%, with several reviews reporting wider ranges depending on measurement and setting. Distress is consistently associated with advanced disease severity (New York Heart Association Class III–IV), high symptom burden, and social isolation. Informal caregivers experience significant emotional, physical, social, and financial strain. Higher burden is associated with greater patient severity/depression, caregiver female sex and spousal status, and limited support. Adaptive coping (problem-solving, social support) links to better outcomes; maladaptive strategies (avoidance, rumination) correlate with greater distress and burnout.

Conclusion

Heart failure care should integrate routine psychosocial assessment, dyadic interventions, and caregiver support. Implementing structured mental health screening, collaborative care models, and respite and navigation services can improve outcomes, enhance quality of life, and sustain caregiving capacity.

Keywords
Heart failure
Psychological distress
Caregiver burden
Coping strategies
Dyadic care
Funding
None.
References
  1. Savarese G, Becher PM, Lund LH, Seferovic P, Rosano GMC, Coats AJS. Global burden of heart failure: a comprehensive and updated review of    Cardiovasc Res. 2023;118(17):3272-3287.  doi: 10.1093/cvr/cvac013

 

  1. Martin SS, Aday AW, Almarzooq ZI, et al. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart  Circulation. 2024;149(8):e347-e913.   doi:  10.1161/CIR.0000000000001209

 

  1. Arndt MB, Abate YH, Abbasi-Kangevari M, et al. Global, regional, and national progress towards the 2030 global nutrition targets and forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2021. The Lancet. 2024;404(10471):2543-2583. doi: 10.1016/s0140-6736(24)01821-x

 

  1. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA Guideline for the Management of  Heart  Failure: A Report of  the  American  College  of  Cardiology/ American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895-e1032.   doi: 10.1161/CIR.0000000000001063

 

  1. Shi J, Yu X, Liu Z. A Review of New-Onset Ventricular Arrhythmia after Left Ventricular Assist Device  Cardiology. 2022;147(3):315-327. doi: 10.1159/000524779

 

  1. Levine GN, Carney RM, Cohen BE, et al. Post-Myocardial Infarction  Psychological Distress: A Scientific Statement From the American  Heart  Circulation. 2025;152(16):e298-e310.  doi: 10.1161/CIR.0000000000001381

 

  1. Han Y, Sun W, Han J, Li S, Zhou Y. Effects of six traditional Chinese mind-body exercise therapies on vascular health and cardiac function in middle-aged and elderly hypertensive patients: A network meta-analysis of 48 randomized con- trolled trials. Ageing Res Rev. 2025;115:103007. doi: 10.1016/j.arr.2025.103007

 

  1. Wan B, Wang Y, Lv Q, et al. Conjoint trajectories of anxiety and depression in patients with heart failure and their caregivers within 3 months  post-discharge:  exploring  their interconnections with dyadic burdens using network    Eur  J  Cardiovasc Nurs. 2025;24(8):1287-1296.  doi: 10.1093/eurjcn/zvaf126

 

  1. Yingnan Z, Shulin Z, Minxia L, Qiao Z, Xiaoqing S. Patient and informal caregiver-centered nursing interventions for adults with heart failure: A systematic review and meta-analysis. Intensive Crit Care Nurs. 2025;88:103943. doi: 10.1016/j.iccn.2025.103943

 

  1. Taylor E, Sparks D, Rukavina M, Biddle M, Wells GL. Nurse-led positive psychology intervention is feasible in patients with heart failure. J Cardiovasc Nurs.  2021;36(2):131-135. doi: 10.1097/JCN.0000000000000758

 

  1. Ngamvichchukorn T, Ruengorn C, Noppakun K, Thavorn K, Hutton B, Sood MM, Knoll GA, Nochaiwong  Association Between Pretransplant   Dialysis   Modality and Kidney Transplant Outcomes: A Systematic Review  and  Meta-analysis.  JAMA Netw Open.  2022;5(10):e2237580.  doi: 10.1001/jamanetworkopen.2022.37580

 

  1. Huang Y, Zhang Y, Zhang Y, et al. Hearing impairment, psychological  distress, and incident heart failure: a prospective cohort study.  Heart.  2025;111(18):877-883. doi: 10.1136/heartjnl-2024-325394

 

  1. IsHak WW, Hamilton MA, Korouri S, et al. Comparative effectiveness of psychotherapy vs antidepressants for depression in heart failure: a randomized clinical trial. JAMA Netw Open. 2024;7(1):e2352094. doi: 10.1001/jamanetworkopen.2023.52094

 

  1. Celano CM, Golden J, Healy BC, Longley RM, Huffman JC. Predictors of completion and response to a psychological intervention to promote health behavior adherence in heart failure. Int J Psychiatry Med. 2022;57(1):21-34. doi: 10.1177/0091217421989830

 

  1. Bajwah S, Oluyase AO, Yi D, et al. The effective- ness and cost-effectiveness of hospital-based specialist palliative  care  for  adults with advanced illness and their caregivers. Cochrane Database Syst Rev. 2020;9(9):CD012780. doi: 10.1002/14651858.CD012780.pub2

 

  1. Beheshtaeen F, Molazem  Z, Kalyani MN, Mohebbi  Z,  Moshfeghinia  R,  Rad MG. Caregiver burden in informal caregivers of cardiac patients: a mixed-methods systematic review. BMC Psychol. 2026. doi: 10.1186/s40359-026-03973-0

 

  1. Nijskens CM, Schouten AEM, MacNeil-Vroomen JL, Thomas EG, van der Meulen MP, Muller M. Program theory and economic insights of a comprehensive geriatric assessment for frail heart failure patients. BMC Geriatr. 2025;25(1):1006. doi: 10.1186/s12877-025-06718-7

 

  1. Suthershinii G, Tan WA, Lee ARYB, Chen MZ. Behavioral interventions for the patient-caregiver unit in patients with chronic heart failure: a systematic review of caregiver out- comes. J Multidiscip Healthc. 2022;15:921-939. doi: 10.2147/JMDH.S357179

 

  1. Graven LJ, Azuero A, Abbott L, Grant JS. Psychosocial factors related to adverse out- comes in heart failure caregivers: a structural equation modeling analysis. J Cardiovasc Nurs. 2020;35(2):137-148.  doi: 10.1097/JCN.0000000000000634

 

  1. Graven LJ, Kitko L, Abshire Saylor M, et al. Palliative care  and  advanced  cardiovascular disease in adults: not just end-of- life care: a scientific statement from the American  Heart  Circulation. 2025;151(21):e1030-e1042.  doi: 10.1161/CIR.0000000000001323

 

  1. Khan KR, Khan OA, Chen C, et al. Impact of Moderate Aortic Stenosis in Patients With Heart Failure With Reduced Ejection Fraction. J Am Coll Cardiol. 2023;81(13):1235-1244. doi: 10.1016/j.jacc.2023.01.032

 

  1. Manolis TA, Manolis AA, Manolis AS. Cognitive Behavioral Therapy in Cardiovascular Disease. CVP. 2025;23(2):77-97. doi: 10.2174/0115701611302479241010104240

 

  1. Sukumar S, Flashner L, Logeman JL, O’Shea LK, Warraich HJ. Palliative care for older adults with cardiovascular disease. Ann Palliat Med. 2024;13(4):828-841.  doi: 10.21037/apm-23-519

 

  1. Garcia R, Gras D, Mansourati J, et al. Impact and safety of remote monitoring of heart failure patients managed with the HeartLogic algorithm: the HeartLogic France Cohort Study. Eur Heart J Digit Health. 2025;7(2):ztaf133. doi: 10.1093/ehjdh/ztaf133

 

  1. Wang Y, Guo X, Wang Y, Guo N, Yang Q. Quality of relationship, depression, and sleep quality in patients with chronic heart failure and their spouse: an actor-partner interdependence model. BMC Nurs. 2025;24(1):1070. doi: 10.1186/s12912-025-03711-8

 

  1. Iyngkaran P, Smith D, McLachlan C, Battersby M, De Courten M, Hanna F. Validation of Psychometric Properties  of  Partners  in Health Scale for Heart Failure. J Clin Med. 2024;13(23):7374. doi: 10.3390/jcm13237374

 

  1. Healey EL, Mallen CD, Chew-Graham CA, et al. Integrating case-finding and initial management for osteoarthritis, anxiety, and depression into primary care long-term condition reviews: results from the ENHANCE pilot trial. Fam Pract. 2022;39(4):592-602. doi: 10.1093/fampra/cmab113

 

  1. Sumaqa YA, Hayajneh FA, Alhamory S, et al. Consequences of Psychological Aspects: From Jordanian Heart Failure Patients’ Beliefs. SAGE Open Nurs. 2023;9:23779608231189128. doi: 10.1177/23779608231189128

 

  1. Lin CY, Dracup K, Pelter MM, Biddle MJ, Moser DK. Association of psychological distress with reasons for delay in seeking medical care in rural patients with worsening heart failure symptoms. J Rural Health. 2022;38(4):713-720. doi: 10.1111/jrh.12573

 

  1. Naghavi M, Kyu HH, Bhoomadevi A, et al. Global burden of 292 causes of death in 204 countries and territories and 660 subnational locations, 1990–2023: a systematic analysis for the Global Burden of Disease Study 2023. The Lancet. 2025;406(10513):1811-1872. doi: 10.1016/s0140-6736(25)01917-8

 

  1. Easton K, Coventry P, Lovell K, Carter LA, Deaton C. Prevalence and measurement of anxiety in samples of patients with heart failure: meta-analysis. J Cardiovasc Nurs. 2016;31(4):367-379.  doi: 10.1097/JCN.0000000000000265

 

  1. Lee W, Pulbrook M, Sheehan C, et al. Clinically Significant Depressive Symptoms Are Prevalent in People With Extremely Short Prognoses-A Systematic Review. J Pain Symptom Manage. 2021;61(1):143-166.e2. doi: 10.1016/j.jpainsymman.2020.07.011

 

  1. Sbolli M, Fiuzat M, Cani D, O’Connor CM. Depression and heart failure: the lonely comorbidity. Eur J Heart Fail. 2020;22(11):2007-2017. doi: 10.1002/ejhf.1865

 

  1. Freedland KE, Skala JA, Steinmeyer BC, Carney RM, Rich MW. Effects of Depression on Heart Failure Self-Care. J Card Fail. 2021;27(5):522- 532. doi: 10.1016/j.cardfail.2020.12.015

 

  1. Gottlieb SS, Khatta M, Friedmann E, et al. The influence of age, gender, and race on the prevalence of depression in heart failure patients. J Am Coll Cardiol. 2004;43(9):1542-1549. doi: 10.1016/j.jacc.2003.10.064

 

  1. Schiffer AA, Pedersen SS, Widdershoven JW, Denollet J. Type D personality and depressive symptoms are independent predictors of impaired health status in chronic heart fail- ure. Eur J Heart Fail. 2008;10(8):802-810. doi: 10.1016/j.ejheart.2008.06.012

 

  1. Konstam V, Moser DK, De Jong MJ. Depression and anxiety in heart failure. J Card Fail. 2005;11(6):455-463. doi: 10.1016/j.cardfail.2005.03.006

 

  1. Almuwaqqat Z, Liu C, Ko YA, et al. Posttraumatic stress disorder and the risk of heart failure hospitalizations among individuals with cor- onary artery disease. Circ Cardiovasc Qual Outcomes. 2024;17(12):e011040. doi: 10.1161/CIRCOUTCOMES.124.011040

 

  1. Gharzeddine R, McCarthy MM, Yu G, Dickson VV. Insomnia and Insomnia Symptoms in Persons With Heart Failure: An Integrative Review. J Cardiovasc Nurs. 2021;36(4):374-384. doi: 10.1097/JCN.0000000000000719

 

  1. Luo YT, Ou AZ, Lin DS, et al. Status of anxiety and depression among chronic heart failure patients: factors influencing poor fluid restriction   World  J Psychiatry. 2025;15(6):103765.  doi: 10.5498/wjp.v15.i6.103765

 

  1. Gostoli S, Subach R, Guolo F, et al. Care man- ager role for older multimorbid heart failure patients’ needs in relation to psychological distress and quality of life: a cross-sectional study. Front Cardiovasc Med. 2024;11:1432588. doi: 10.3389/fcvm.2024.1432588

 

  1. Wang J, Cui J, Yang X, et al. The effects of frailty, mental health, and cardiac function on quality of life in patients undergoing transcatheter aortic valve replacement. Sci Rep. 2025;15(1):22440. doi: 10.1038/s41598-025-04859-8

 

  1. Żółkowska B, Lee CS, Denfeld QE, et al. Clinical and psychological factors associated with frailty in patients with heart failure. J Clin Med. 2024;13(23):7345. doi: 10.3390/jcm13237345

 

  1. Thotakura B, Vidya S, Sheena KS, Roy DD, Prabhu K, Jones S. A review of contributing factors to heart failure: genetic, lifestyle, and environmental influences. J Pharm Bioallied Sci. 2024;16(Suppl 5):S4299-S4305. doi: 10.4103/jpbs.jpbs_1328_24

 

  1. Triposkiadis F, Xanthopoulos A, Parissis J, Butler J, Farmakis D. Pathogenesis of chronic heart failure: cardiovascular aging, risk factors, comorbidities, and disease modifiers. Heart Fail Rev. 2022;27(1):337-344. doi: 10.1007/s10741-020-09987-z

 

  1. D’Souza PJJ, Lewis MS, Paramasivam G, et al. Factors associated with self-care behavior among heart failure patients in India: a systematic review. J Educ Health Promot. 2025;14:344. doi: 10.4103/jehp.jehp_1778_24

 

  1. Noma S, Kato K, Otsuka T, et al. Sex differences in cardiovascular disease-related hospitalization and mortality in Japan: analysis of health records from a nationwide claim- based database, the Japanese Registry of All Cardiac and Vascular Disease (JROAD). Circ J. 2024;88(8):1332-1342. doi: 10.1253/circj.CJ-23-0960

 

  1. Ferguson LD, Molenberghs G, Verbeke G, et al. Gout and incidence of 12 cardiovascular diseases: a case-control study including 152 663 individuals with gout and 709 981 matched controls. Lancet Rheumatol. 2024;6(3):e156-e167. doi: 10.1016/S2665-9913(23)00338-7

 

  1. Smolderen KG, Gillaspy S, Evers AWM, et al. The Role of the Clinical Psychologist in the Care of Adults With Cardiovascular Disease. JACC Adv. 2024;3(4):100910.  doi: 10.1016/j.jacadv.2024.100910

 

  1. Lukas E, Veeneman RR, Smit DJA, et al. A genetic exploration of the relationship between post- traumatic stress disorder and cardiovascular diseases. Transl Psychiatry. 2025;15(1):1. doi: 10.1038/s41398-024-03197-z

 

  1. Religioni U, Sawicka A, Niegowska W, et al. Sociodemographic, disease-related and life- style determinants of health-related quality of life among older patients hospitalized with heart failure. Sci Rep. 2025;15(1):31040. doi: 10.1038/s41598-025-13881-9

 

  1. Li Y, Xiong X, Wang H, et al. Positive psycho- logical experiences in chronic heart failure: a qualitative meta-synthesis. J Adv Nurs. 2025;81(12):8564-8578. doi: 10.1111/jan.16824

 

  1. Vigorè M, Granata N, Braga SS, et al. Cognitive impairment, frailty and rehabilitation out- come in  older  cardiorespiratory patients. DEC_FRAinRIAB: Study protocol. PLoS One. 2022;17(8):e0272132.  doi: 10.1371/journal.pone.0272132

 

  1. Kitko L, McIlvennan CK, Bidwell JT, et al. Family caregiving for individuals with heart failure: a  scientific  statement  from  the American  Heart  Circulation. 2020;141(22):e864-e878.   doi: 10.1161/CIR.0000000000000768

 

  1. Zhang S, Liu C, Wu P, et al. Burden and temporal trends of valvular heart disease-related heart failure from 1990 to 2019 and projection up to 2030 in Group of 20 countries: an analysis for the Global Burden of Disease Study 2019. J Am Heart Assoc. 2024;13(20):e036462. doi: 10.1161/JAHA.124.036462

 

  1. Li J, Feng L, Shui X, Deng C, Hu A. Relationship between symptom burden and self-management among patients with chronic heart failure: a cross-sectional study. Patient Prefer Adherence. 2023;17:1909-1921. doi: 10.2147/PPA.S419796

 

  1. Locatelli G, Iovino P, Pasta A, Jurgens CY, Vellone E, Riegel B. Cluster analysis of heart failure patients based on their psychological and physical symptoms and predictive analysis of cluster membership. J Adv Nurs. 2024;80(4):1380-1392. doi: 10.1111/jan.15890

 

  1. Ly R, Karsenty C, Amedro P, et al. Health- Related Quality of Life and Its Association With Outcomes in Adults With Congenital Heart Disease and Heart Failure: Insight From FRESH-ACHD Registry. J Am Heart Assoc. 2023;12(8):e027819.  doi: 10.1161/JAHA.122.027819

 

  1. Fudim M, Cerbin LP, Devaraj S, Ajam T, Rao SV, Kamalesh M. Post-traumatic stress disorder and heart failure in men within the Veteran Affairs health system. Am J Cardiol. 2018;122(2):275- 278. doi: 10.1016/j.amjcard.2018.04.007

 

  1. Wilson MA, Liberzon I, Lindsey ML, et al. Common pathways  and  communication between the brain and heart: connecting post-traumatic stress disorder and heart failure.  Stress.  2019;22(5):530-547. doi: 10.1080/10253890.2019.1621283

 

  1. Parati G, Lombardi C, Castagna F, Mattaliano P, Filardi PP, Agostoni P. Heart failure and sleep disorders. Nat Rev Cardiol. 2016;13(7):389-403. doi: 10.1038/nrcardio.2016.71

 

  1. Yang M, Chimura M, Lam CSP, et al. Finerenone and quality of life assessed using the EuroQol 5-dimension questionnaire level-sum-score in patients with heart failure and mildly reduced or preserved ejection fraction. JACC Heart Fail. 2025. doi: 10.1016/j.jchf.2025.102705

 

  1. Durante A, Ahtisham Y, Cuoco A, et al. Informal caregivers of people with heart failure and resilience: a  convergent  mixed methods study. J Adv Nurs. 2022;78(1):264-275. doi: 10.1111/jan.15078

 

  1. Freedland KE, Steinmeyer BC, Skala JA, Carney RM, Rich MW. Patient-Reported Social Determinants of Health in Patients With Heart Failure. J Am Heart Assoc. 2025;14(10):e041458. doi: 10.1161/JAHA.124.041458

 

  1. Kim KA, Park JS, Seo KW, Choi EY, Ahn JA. Factors affecting the quality of life of family caregivers of patients with heart failure: A cross-sectional study. Medicine (Baltimore). 2022;101(35):e30042. doi: 10.1097/MD.0000000000030042

 

  1. Harrison DJ, Kay J, Jacobsen RM, et al. The bur- den of psychological trauma and post-traumatic stress disorder among adults with congenital heart disease: PTSD in ACHD. Am J Cardiol. 2024;219:9-16. doi: 10.1016/j.amjcard.2024.03.007

 

  1. Scott LD. Caregiving and care receiving among a technologically dependent heart failure pop- ulation. ANS Adv Nurs Sci. 2000;23(2):82-97. doi: 10.1097/00012272-200012000-00008

 

  1. Piamjariyakul U, Young S, Smothers A, et al. Study protocol of sustaining home palliative care for patients with Heart Failure (HF) and their family caregivers in rural Appalachia: a mixed methods randomized clinical trial. BMC Palliat Care.  2025;24(1):56.  doi:  1186/s12904-025-01680-y

 

  1. Humphrey L,  Kulich  K,  Deschaseaux C, Blackburn S, Maguire L, Strömberg A. The Caregiver Burden Questionnaire for Heart Failure (CBQ-HF): face and content validity. Health Qual Life Outcomes. 2013;11:84. doi: 10.1186/1477-7525-11-84

 

  1. Cheung A, Kuti EL, Osenenko KM, Friesen M, Donato BMK. Impact of caring for individuals with heart failure in the United States: a systematic literature review. J Cardiovasc Nurs. 2024;39(2):128-141.  doi: 10.1097/JCN.0000000000001005

 

  1. Niu Y, Shao Y, Chen L, Zhang X. The Dyadic Relationship of Illness Uncertainty, Social Support, and Coping Styles in Patients with OSA and  Their  Co-Residents:  An  Actor- Partner Interdependence Mediation Model Analysis. Nat Sci Sleep. 2025;17:2501-2516. doi: 10.2147/NSS.S558190

 

  1. Baik D, McIlvennan CK, Baker C, Coats H. Caregiving experiences of older family caregivers of persons with heart failure: a mixed methods study. Geriatr Nurs. 2022;48:51-57. doi: 10.1016/j.gerinurse.2022.08.015

 

  1. Bahrami M, Etemadifar S, Shahriari M, Farsani AK. Caregiver burden among Iranian heart failure family caregivers: a descriptive, exploratory, qualitative study. Iran J Nurs Midwifery Res. 2014;19(1):56-63.

 

  1. Valleggi A, Passino C, Emdin M, Murante AM. Differences in family caregiver experiences and expectations of end-of-life heart failure care across providers and settings: a systematic literature review. BMC Health Serv Res.  2023;23(1):429.  doi: 10.1186/s12913-023-09241-w

 

  1. Nguyen DD, Spertus JA, Benton MC, et al. Association of Patient Reported Outcomes With Caregiver Burden in Older Patients With Advanced  Heart  Failure:  Insights From  the  SUSTAIN-IT  Circ Heart Fail.  2024;17(7):e011705.  doi: 10.1161/CIRCHEARTFAILURE.124.011705

 

  1. Gilotra NA, Pamboukian  SV, Mountis M, et  al.  Caregiver  Health-Related  Quality of  Life,  Burden,  and  Patient  Outcomes in  Ambulatory  Advanced  Heart  Failure: A  Report  From    J  Am  Heart Assoc.  2021;10(14):e019901.  doi:  10.1161/JAHA.120.019901

 

  1. Suksatan W, Tankumpuan T, Davidson PM. Heart Failure Caregiver Burden and Outcomes: A Systematic Review. J Prim Care Community Health. 2022;13:21501319221112584. doi: 10.1177/21501319221112584

 

  1. Thodi M, Bistola V, Lambrinou E, et al. A randomized trial of a nurse-led educational intervention in patients with heart failure and their caregivers: impact on caregiver outcomes. Eur J Cardiovasc Nurs. 2023;22(7):709-718. doi: 10.1093/eurjcn/zvac118

 

  1. Liu F, Zhang H, Li S, Wang X, Long X, Liu Y. Interventions for reducing caregiver burden in chronic dyspnea: a meta-analysis. Front Public Health. 2025;13:1659063. doi: 10.3389/fpubh.2025.1659063

 

  1. Säfström E, Liljeroos M. Personalizing care for informal heart failure caregivers: challenges and  practical  Curr Heart Fail Rep. 2025;22(1):14. doi: 10.1007/s11897-025-00703-2

 

  1. Glickman A, Mikulich-Gilbertson S, Abshire Saylor M,  DeGroot  L,  Bekelman DB. Relationship status and quality are associated with perceived benefits of caregiving for people with heart failure. J Cardiovasc Nurs.  2025;40(4):E160-E166.  doi: 10.1097/JCN.0000000000001093

 

  1. Hu X, Huang W, Su Y, Qu M, Peng X. Depressive symptoms in Chinese family caregivers of patients with heart failure: a cross-sectional study. Medicine.  2017;96(13):e6480.  doi: 10.1097/MD.0000000000006480

 

  1. Lahoz R, Proudfoot C, Fonseca AF, et al. Caregivers of patients with heart failure: burden and the determinants of health-related quality of life. Patient Prefer Adherence. 2021;15:1153-1164. doi: 10.2147/PPA.S297816

 

  1. Graven LJ, Boel-Studt S, Buck HG, Abbott L, Grant JS. Heart failure caregiver self-care: a latent class analysis. Clin Nurs Res. 2021;30(5):625- 635. doi: 10.1177/1054773820973121

 

  1. Abshire Saylor M, DeGroot L, Pavlovic N, et al. The context of caregiving in heart failure: a dyadic, mixed methods analysis. J Cardiovasc Nurs. 2023;38(4):370-378.  doi: 10.1097/ JCN.0000000000000987

 

  1. Freedland KE, Skala JA, Carney RM, Steinmeyer BC, Rubin  EH,  Rich  Sequential Interventions for Major Depression and Heart Failure Self-Care: A Randomized Clinical Trial. Circ Heart Fail. 2022;15(8):e009422. doi: 10.1161/CIRCHEARTFAILURE.121.009422

 

  1. Wang Y, Xu X, Lv Q, Zhao Y, Zhang X, Zang X. Network analysis of dyadic burdens, psychological disorders,  psychological resilience, and illness- or caregiving-related beliefs in patients with chronic heart failure and their caregivers. J Cardiovasc Nurs. 2025;40(4):312- 322. doi: 10.1097/JCN.0000000000001098

 

  1. Niitani M, Sawatari H, Takei Y, Yamashita N. Associated factors for quality of life, anxiety, and depression in patients with chronic heart failure and their family caregivers: a cross-sectional study in Japan. Palliat Med Rep. 2024;5(1):585-594. doi: 10.1089/pmr.2024.0056

 

  1. Pinquart M,  Sörensen    Correlates  of physical health of informal caregivers: A meta-analysis. J Gerontol B Psychol Sci Soc Sci.  2007;62(2):P126-P137.  doi: 10.1093/geronb/62.2.p126

 

  1. van den Heuvel LM, Sarina T, Sweeting J, et al. A prospective longitudinal study of health-related quality of life and psychological wellbeing after an implantable cardioverter-defibrillator in patients with genetic heart diseases. Heart Rhythm O2. 2022;3(2):143-151. doi: 10.1016/j.hroo.2022.02.003

 

  1. Voltolini A, Salvato G, Frigerio M, et al. Psychological outcomes of left ventricular assist device long-term treatment: a 2-year follow-up study. Artif Organs. 2020;44(1):67-71. doi: 10.1111/aor.13531

 

  1. Celano CM, Freedman ME, Harnedy LE, et al. Feasibility and preliminary efficacy of a positive psychology-based intervention to promote health behaviors in heart failure: the REACH for Health study. J Psychosom Res. 2020;139:110285.  doi: 10.1016/j.jpsychores.2020.110285

 

  1. Tang F, Li K, Rauktis ME, Farmer EMZ, McDaniel S. Stress, Coping, and Quality of Life Among Custodial Grandparents. J Gerontol Soc Work. 2023;66(3):354-367. doi: 10.1080/01634372.2022.2103764

 

  1. Alanazi MO, Deka P, Given CW, Lehto R, Wyatt G. Coping strategies and health-related quality of life in individuals with heart failure. J Clin Med. 2025;14(9):3073. doi: 10.3390/jcm14093073

 

  1. Yan Y, Huang Y, Wang MP, Lau KK, Anderson CS, Lee JJ. Dyadic Interventions for Promoting Healthy Diets in Patients With Cardiovascular Disease: A Systematic Review and Meta- Analysis. Nurs Health Sci. 2025;27(3):e70183. doi: 10.1111/nhs.70183

 

  1. Yang Z, Huang H, Xu L, Gao Y, Zhang C, Wang A. From need to action: decoding the role of motivation in adherence to home-based cardiac rehabilitation exercise in chronic heart failure patients. BMC Nurs. 2024;23(1):913. doi: 10.1186/s12912-024-02617-1

 

  1. Tang M, Zhao R, Lv Q. Status and influencing factors of frailty in hospitalized patients with chronic heart failure: a cross-sectional study. J Clin Nurs. 2025;34(1):194-203. doi: 10.1111/jocn.17324

 

  1. Carrillo A, Belnap BH, Rothenberger SD, Feldman R, Rollman BL, Celano  Psychosocial predictors of health behavior adherence in heart-failure patients with comorbid depression: a secondary analysis of the Hopeful Heart trial. BMC Psychol. 2024;12(1):328. doi: 10.1186/s40359-024-01816-4

 

  1. Sachdev V, Sharma K, Keteyian SJ, et al. Supervised Exercise Training for Chronic Heart Failure  With  Preserved  Ejection Fraction:  A  Scientific  Statement From the  American  Heart  Association and American College of Cardiology. Circulation. 2023;147(16):e699-e715.  doi: 10.1161/CIR.0000000000001122

 

  1. Brar R, Whitlock RH, Katz A, et al. Impact of a Medical Fitness Model on Incident Major Adverse Cardiovascular Events: A Prospective Cohort Study of 11 000 Members. J Am Heart Assoc. 2024;13(7):e030028.  doi:  1161/JAHA.123.030028

 

  1. Taylor RS, Ding C. Importance of health-related quality of gain with exercise training in preserved ejection fraction heart failure. Eur Heart J Open. 2024;4(6):oeae091. doi: 10.1093/ehjopen/oeae091

 

  1. Gass F, Halle M, Mueller S. Telemedicine acceptance and efficacy in the context of preventive cardiology interventions: a systematic review. Digit Health. 2022;8:205520762211141. doi: 10.1177/20552076221114186

 

  1. Santos GC, Liljeroos M, Dwyer AA, et al. Symptom perception in heart failure - Interventions and outcomes: A scoping review. Int J Nurs Stud. 2021;116:103524. doi: 10.1016/j.ijnurstu.2020.103524

 

  1. Zhang Y, Zhang H, Zhang Y, et al. Effect of MBSR, DBT and CBT on the hypertension patients with depression/anxiety: Protocol of a systematic review and Bayesian network meta-analysis. PLoS One. 2023;18(2):e0281469. doi: 10.1371/journal.pone.0281469

 

  1. Wang X, Song C. The impact of gratitude interventions on patients with cardiovascular disease:  a  systematic  Front Psychol.  2023;14:1243598.  doi: 10.3389/fpsyg.2023.1243598

 

  1. Golan M, Vilchinsky N, Wolf H, Abuhazira M, Ben-Gal T, Naimark A. Couples’ coping strategies with left ventricular assist device implantation: a qualitative dyadic study. Qual Health Res.  2023;33(8-9):741-752. doi: 10.1177/10497323231168580

 

  1. Yu DS, Qiu C, Li PWC, Lau J, Riegel B. Effects of dyadic care interventions for heart failure on patients’ and caregivers’ outcomes: a systematic review, meta-analysis and meta-regression. Int J Nurs Stud. 2024;157:104829. doi: 10.1016/j.ijnurstu.2024.104829

 

  1. Cassidy L, Thompson G, Hill L, et al. Co-design and feasibility testing of the heart failure carer support programme (HELP): a convergent, mixed-method study. Patient Educ Couns. 2025;136:108760.  doi: 10.1016/j.pec.2025.108760

 

  1. Zhou T, Hu Y, Zhu L, et al. Effects of home disease management strategies based on the dyadic illness management theory on elderly patients with chronic heart failure and informal caregivers’ physical and psychological outcomes: a randomized controlled trial. Front 2025;12:1679743. doi: 10.3389/fmed.2025.1679743

 

  1. Xiang H, Liu L, Su X, et al. The association between a stress-is-enhancing mindset and internet gaming disorder was mediated by behavioral disengagement  among medical undergraduate students: a multi-center survey in China. BMC Psychiatry. 2025;25(1):472. doi: 10.1186/s12888-025-06910-4

 

  1. Prati G, Mancini AD. Social and behavioral consequences of the COVID-19 pandemic: Validation of  a  Pandemic  Disengagement Syndrome Scale (PDSS) in four national con- texts. Psychol Assess. 2023;35(11):1041-1053. doi: 10.1037/pas0001213

 

  1. Korosec-Serfaty M,  Riedl  R,  Sénécal S, Léger    Attentional  and  Behavioral Disengagement  as  Coping  Responses  to Technostress  and  Financial  Stress:  An Experiment  Based  on Psychophysiological, Perceptual,  and  Behavioral  Data.  Front Neurosci.  2022;16:883431.  doi: 10.3389/fnins.2022.883431

 

  1. Wang X, Yang J, He J. Attentional disengagement difficulties toward game-related social reward and avoidance toward real-life social reward among individuals with Internet gaming disorder. J Psychiatr Res. 2025;189:244-251. doi: 10.1016/j.jpsychires.2025.05.041

 

  1. Helal SI, Lee G, Evans C, Grealish A. The Efficacy of Psychological Interventions on Health- Related Quality of Life for Patients With Heart Failure and Depression: A Systematic Review. J Cardiovasc Nurs.  2022;37(2):134-145. doi: 10.1097/JCN.0000000000000779

 

  1. Wang Y, Fu T, Wang J, Chen S, Sun G. The relationship between  self-compassion,  coping style, sleep quality, and depression among college students. Front Psychol. 2024;15:1378181. doi: 10.3389/fpsyg.2024.1378181

 

  1. Philippi CL, Leutzinger K, Pessin S, et al. Neural signal variability relates to maladaptive rumination in depression. J Psychiatr Res. 2022;156:570-578.  doi: 10.1016/j. jpsychires.2022.10.070

 

  1. Alanazi MO, Given CW, Deka P, Lehto R, Wyatt G. A literature review of coping strategies and health-related quality of life among patients with heart failure. Eur J Cardiovasc Nurs. 2023;22(3):236-244. doi: 10.1093/eurjcn/zvac042

 

  1. Andonian C, Beckmann J, Ewert P, et al. Assessment of the psychological situation in adults with congenital heart disease. J Clin Med. 2020;9(3):779. doi: 10.3390/jcm9030779

 

  1. Lee K, Ota K, Toma T, Toriya M. Perceptions of “Healthy Life Expectancy” of Individuals With Diseases: An Online Survey in Japan. Health Sci Rep. 2025;8(12):e71533. doi: 10.1002/ hsr2.71533

 

  1. Mira Hernandez J, Shen EY, Ko CY, et al. Differential sex-dependent susceptibility to diastolic dysfunction and arrhythmia in cardio- myocytes from obese diabetic heart failure with preserved ejection fraction model. Cardiovasc Res. 2025;121(2):254-266. doi: 10.1093/cvr/cvae070

 

  1. Lala A, Tayal U, Hamo CE, et al. Sex Differences in Heart Failure. J Card Fail. 2022;28(3):477- 498. doi: 10.1016/j.cardfail.2021.10.006

 

  1. Rosano GMC, Stolfo D, Anderson L, et al. Differences in presentation, diagnosis and management of heart failure in women. A scientific statement of the Heart Failure Association of the ESC. Eur J Heart Fail. 2024;26(8):1669- 1686. doi: 10.1002/ejhf.3284

 

  1. Wang Y, Wang Y, Chen X, et al. Trajectories and Co-Occurrence  of  Perceived Control in Patients With Heart Failure and Self- Efficacy in Their Caregivers: A Three-Month Longitudinal Study of Dual Trajectories. J Clin Nurs.  2026;35(3):1244-1257.  doi: 10.1111/jocn.70072

 

  1. Vigorè M, Sattin D, Maestri R, et al. Beyond the heart: The role of psychological factors and coping strategies in cardiovascular rehabilitation. Int J Cardiol. 2025;428:133144. doi: 10.1016/j.ijcard.2025.133144

 

  1. Grant JS, Graven LJ, Schluck G, Abbott L. Psychosocial predictors of adverse outcomes in rural heart failure caregivers. Rural Remote Health. 2021;21(3):6497.  doi:  22605/RRH6497

 

  1. Yan J, Zhou L, Song G, Yuan Y. The chain mediating role of social support and yielding coping style between health literacy and symptom burden in patients with chronic heart failure. Front Cardiovasc Med. 2025;12:1518175. doi: 10.3389/fcvm.2025.1518175

 

  1. Xiang L, Wang J, Li W, Ye H. A Study on the Current Situation and Related Factors of Personal Mastery in Patients with Chronic Heart Failure: A Cross-Sectional Study. Int J Gen Med. 2024;17:4701-4710. doi: 10.2147/IJGM.S483987

 

  1. Cassidy L, Hill L, Fitzsimons D, McGaughey J. The impact of psychoeducational interventions on the outcomes of caregivers of patients with heart failure: A systematic review and meta-analysis. Int J Nurs Stud. 2021;114:103806. doi: 10.1016/j.ijnurstu.2020.103806

 

  1. Locatelli G, Fabrizi D, Ausili D, Vellone E. Dyadic symptom recognition in heart failure. Eur J Cardiovasc Nurs. 2025;24(6):873-882. doi: 10.1093/eurjcn/zvaf051

 

  1. Young S, Smith M, Shafique S, Piamjariyakul U. You’re not who you used to be: a case report of a family living with heart failure and vascular dementia. Home Healthc Now. 2023;41(3):140- 148. doi: 10.1097/NHH.0000000000001165

 

  1. O’Donnell A, Gonyea JG, Leff V. Social work involvement in palliative care heart failure research: a review of recent literature. Curr Opin Support Palliat Care. 2020;14(1):3-8. doi: 10.1097/SPC.0000000000000482

 

  1. Thermaenius I, Udo C, Alvariza A, Lundberg T, Holm M, Lövgren M. The Family Talk Intervention Among Families Affected by Severe Illness: Hospital Social Workers’ Experiences of Facilitators and Barriers to its Use in Clinical Practice. J Soc Work End Life Palliat Care. 2024;20(3):235-253. doi: 10.1080/15524256.2024.2364589

 

  1. El-Dassouki N, Pfisterer K, Benmessaoud C, et al. The value of technology to support dyadic caregiving for individuals living with heart failure: qualitative descriptive study. J Med Internet Res. 2022;24(9):e40108. doi: 10.2196/40108

 

  1. Li Y, Li J, Zhang Y, Ding Y, Hu X. The effective- ness of e-Health interventions on caregiver burden, depression, and quality of life in informal caregivers of patients with cancer: a systematic review and meta-analysis of randomized con- trolled trials. Int J Nurs Stud. 2022;127:104179. doi: 10.1016/j.ijnurstu.2022.104179

 

  1. Sheng A, Yu T, Yu Y, Zhang M, Zeng Y, Ye L. Analysis of the integration of medical and nursing care and its association with depression and anxiety among medical staff in the Jinhua area. Front Psychiatry. 2025;16:1616682. doi: 10.3389/fpsyt.2025.1616682

 

  1. Chen Y, Lin Y, Dong X, Xue Y, Wu D. Trajectories and influencing factors of self-care behaviors in Chinese older adults with chronic heart failure: a prospective observational study. Int J Nurs Stud Adv. 2025;9:100418. doi: 10.1016/j.ijnsa.2025.100418

 

  1. De Bacquer D, Ueda P, Reiner Ž, De Sutter J, et al. Prediction of recurrent event in patients with coronary heart disease: the EUROASPIRE Risk Model. Eur J Prev Cardiol. 2022;29(2):328-339. doi: 10.1093/eurjpc/zwaa128

 

  1. Dionne-Odom JN, Ejem DB, Wells R, et al. Effects of a telehealth early palliative care intervention for family caregivers of persons with advanced heart failure: the ENABLE CHF-PC randomized  clinical  JAMA Netw Open. 2020;3(4):e202583. doi: 10.1001/jamanetworkopen.2020.2583

 

  1. Locatelli G, Rebora P, Occhino G, et al. The Impact of an Intervention to Improve Caregiver Contribution to Heart Failure Self-care on Caregiver Anxiety, Depression, Quality of Life, and Sleep. J Cardiovasc Nurs. 2023;38(4):361- 369. doi: 10.1097/JCN.0000000000000998

 

  1. Graven LJ, Abbott L, Boel-Studt S, Grant JS, Buck    Classifying  heart failure  caregivers  as  adequately  or inadequately resourced to care: a latent class analysis. J Palliat Care. 2023;38(1):62-70. doi: 10.1177/08258597221079244

 

  1. Dalirirad H, Najafi T, Seyedfatemi N. Effect of an Educational Support Programme on Caregiver Burden Among the Family Members of Patients Undergoing Coronary Artery Bypass Graft Surgery. Sultan Qaboos Univ Med J. 2021;21(2):e266-e274. doi: 10.18295/squmj.2021.21.02.016

 

  1. Ventoulis I, Kamperidis V, Abraham MR, et al. Differences in Health-Related Quality of Life among Patients with Heart Failure. Medicina (Kaunas). 2024;60(1):109.  doi:  3390/medicina60010109

 

  1. Kubica A,  Pietrzykowski  Ł,  Michalski P. The occurrence of cardiovascular risk factors  and  functioning  in  chronic  illness in the Polish population of EUROASPIRE V. Cardiol J. 2024;31(4):612-620. doi: 10.5603/CJ.a2022.0102

 

  1. Dong X, He D, Zhang Y, Zhao Q, Zhang X, Fan X. Dyadic associations between burden and depressive symptoms among patients with heart failure and their caregivers: the mediating role of perceived stress. J Cardiovasc Nurs. 2023;38(6):517-527.  doi: 10.1097/JCN.0000000000000974

 

  1. Hay SI, Ong KL, Santomauro DF. Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 subnational locations, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet. 2025;406(10513):1873-1922. doi: 10.1016/S0140-6736(25)01637-X

 

  1. Carleton-Eagleton K, Walker I, Freene N, Gibson D, Gibson D. Meeting support needs for informal caregivers of people with heart failure: a rapid review. Eur J Cardiovasc Nurs. 2021;20(5):493-500. doi: 10.1093/eurjcn/zvaa017

 

  1. Mangione CM, Barry MJ, Nicholson WK, et al. Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular  Disease  Prevention  in Adults  Without  Cardiovascular  Disease Risk Factors: US Preventive Services Task Force  Recommendation  JAMA. 2022;328(4):367-374.    doi: 10.1001/jama.2022.10951

 

  1. Wise J. Cognitive behavioural therapy shows promise in heart failure patients with depression. BMJ. 2015;351:h5163. doi: 10.1136/bmj.h5163

 

  1. Eberly LA, Tennison A, Morgan L, et al. Centering Diné (Navajo) voices: barriers, facilitators, and perceptions of cardiac care among patients with heart failure in rural Navajo Nation. Circulation. 2025;152(2):101-112. doi: 10.1161/CIRCULATIONAHA.124.073166

 

  1. Wood M, Walshe C, McCullagh A. What are the digitally enabled psychosocial interventions delivered by trained practitioners being offered to adults with life-shortening illnesses and palliative care needs and their informal and professional caregivers? A scoping review. Palliat Support Care. 2023;21(4):727- 740. doi: 10.1017/S1478951523000172

 

  1. Piña IL, Allen LA, Desai NR. Policy and payment challenges in the postpandemic treatment of heart failure: value-based care and telehealth. J Card Fail. 2022;28(5):835-844. doi: 10.1016/j.cardfail.2021.08.019

 

  1. Giusti A, Pukrittayakamee P, Alarja G, et al. Developing a global practice-based framework of person-centred care from primary data: a cross-national qualitative study with patients, caregivers and healthcare professionals. BMJ Glob Health. 2022;7(7):e008843. doi: 10.1136/bmjgh-2022-008843

 

  1. Dellafiore F, Ghizzardi G, Vellone E, et al. Motivational Interviewing for Enhancing Self- care in Patients With Heart Failure: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2023;12:e44629. doi: 10.2196/44629

 

  1. Shields GE, Rowlandson A, Dalal G, et al. Cost-effectiveness of home-based cardiac rehabilitation: a systematic review. Heart. 2023;109(12):913-920. doi: 10.1136/heartjnl-2021-320459

 

  1. Xiong C, Li PWC, Yu DSF, Wong CWY. How the dyads of heart failure patients and their informal caregivers cope with the disease process: a qualitative evidence synthesis. Int J Nurs Stud. 2025;167:105065. doi: 10.1016/j.ijnurstu.2025.105065
Conflict of interest
The authors declare no competing interests.
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