Interdisciplinary Journal of Nursing and Health (eISSN 3103-537X) continues Infermieristica Journal (eISSN 2785-7018).
Self-Care and Caregiver Contribution to Self-Care in Dyads Receiving Oral Anticancer Treatment (Dyads-in-Cancer): A Protocol for an Observational Longitudinal Study
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Keywords

Self-Care
Oral Anticancer Agents
Cancer Patients
Caregivers
Dyads

How to Cite

Self-Care and Caregiver Contribution to Self-Care in Dyads Receiving Oral Anticancer Treatment (Dyads-in-Cancer): A Protocol for an Observational Longitudinal Study. (2026). Interdisciplinary Journal of Nursing and Health, 5(3). https://doi.org/10.82051/ijnh-2026-462

Abstract

Introduction. The use of oral anticancer agents (OAAs) has increased in recent years. These medications have many benefits, including improved tolerability, adaptability, and decreased stress compared to intravenous treatments. However, studies have shown that there are potential challenges with these treatments, including poor adherence and limited multidisciplinary support. As a result, it is important to focus on self-care behaviours for managing OAA treatment from a dyadic perspective. However, self-care levels in this population and the contribution of informal caregivers to self-care have yet to be extensively described, along with their predictors and outcomes. Therefore, the aim of this study is to describe a research protocol of a multicentre observational longitudinal study designed to investigate the self-care of patients with cancer taking OAAs and the caregivers’ contribution to this self-care, and to examine the self-care predictors and outcomes.

Methods. This study will recruit patients with cancer undergoing OAA treatment and their informal caregivers. Data collection will include patient and caregiver sociodemographic factors, patient clinical information, patient self-care and caregiver contribution to self-care, variables at patient-, caregiver- and dyad-level that can predict self-care and caregiver contribution to self-care. We will also investigate whether self-care and caregiver contribution to self-care can predict important patient outcomes (e.g. emergency room access, rehospitalization, survival, quality of life) and/or caregiver outcomes (e.g. the positive aspects of caregiving). Data analyses will include descriptive statistics, regressions, ANOVAs, structural equation modelling, and dyadic analyses.

Discussion. This research will enhance the understanding of self-care in patients with cancer taking OAA and caregivers’ contribution to self-care. It will provide insights on the factors that influence self-care and important outcomes. The findings of this study will inform future research and guide tailored interventions to improve patient self-care and caregiver support.

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References

Ali, E. E., Cheung, K. L., Lee, C. P., Leow, J. L., Yap, K. Y., & Chew, L. (2017). Prevalence and determinants of adherence to oral adjuvant endocrine therapy among breast cancer patients in Singapore. Asia-Pacific journal of oncology nursing, 4(4), 283-289.

Antonio-Oriola, R., Vellone, E., Durante, A., De Maria, M., Di Nitto, M., Gea-Caballero, V., Santolalla-Arnedo, I., Czapla, M., Benavent-Cervera, J. V., Sánchez-González, J. L., & Juárez-Vela, R. (2022). Spanish Version of the Caregiver Contribution to Self-Care of Heart Failure Index (CC-SCHFI): A Psychometric Evaluation. J Pers Med, 12(4). https://doi.org/10.3390/jpm12040625

Archbold, P. G., Stewart, B. J., Greenlick, M. R., & Harvath, T. (1990). Mutuality and preparedness as predictors of caregiver role strain. Res Nurs Health, 13(6), 375-384. https://doi.org/10.1002/nur.4770130605

Arroll, B., Goodyear-Smith, F., Crengle, S., Gunn, J., Kerse, N., Fishman, T., Falloon, K., & Hatcher, S. (2010). Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Ann Fam Med, 8(4), 348-353. https://doi.org/10.1370/afm.1139

Asendorpf, J. B., van de Schoot, R., Denissen, J. J. A., & Hutteman, R. (2014). Reducing bias due to systematic attrition in longitudinal studies: The benefits of multiple imputation. International Journal of Behavioral Development, 38(5), 453-460. https://doi.org/10.1177/0165025414542713

Ausili, D., Barbaranelli, C., Rossi, E., Rebora, P., Fabrizi, D., Coghi, C., Luciani, M., Vellone, E., Di Mauro, S., & Riegel, B. (2017). Development and psychometric testing of a theory-based tool to measure self-care in diabetes patients: the Self-Care of Diabetes Inventory. BMC Endocr Disord, 17(1), 66. https://doi.org/10.1186/s12902-017-0218-y

Ausili, D., Rebora, P., Di Mauro, S., Riegel, B., Valsecchi, M. G., Paturzo, M., Alvaro, R., & Vellone, E. (2016). Clinical and socio-demographic determinants of self-care behaviours in patients with heart failure and diabetes mellitus: A multicentre cross-sectional study. International Journal of Nursing Studies, 63, 18-27.

Ausili, D., Rossi, E., Rebora, P., Luciani, M., Tonoli, L., Ballerini, E., Androni, S., Vellone, E., Riegel, B., & Di Mauro, S. (2018). Socio-demographic and clinical determinants of self-care in adults with type 2 diabetes: a multicentre observational study. Acta diabetologica, 55, 691-702.

Barillet, M., Prevost, V., Joly, F., & Clarisse, B. (2015). Oral antineoplastic agents: how do we care about adherence? Br J Clin Pharmacol, 80(6), 1289-1302. https://doi.org/10.1111/bcp.12734

Berry, D. L., Blonquist, T. M., Hong, F., Halpenny, B., & Partridge, A. H. (2015). Self-reported adherence to oral cancer therapy: relationships with symptom distress, depression, and personal characteristics. Patient Prefer Adherence, 9, 1587-1592. https://doi.org/10.2147/ppa.S91534

Bidwell, J. T., Vellone, E., Lyons, K. S., D'Agostino, F., Riegel, B., Juárez‐Vela, R., Hiatt, S. O., Alvaro, R., & Lee, C. S. (2015). Determinants of heart failure self‐care maintenance and management in patients and caregivers: a dyadic analysis. Research in Nursing & Health, 38(5), 392-402.

Blanchette, P. S., Lam, M., Richard, L., Allen, B., Shariff, S. Z., Vandenberg, T., Pritchard, K. I., Chan, K. K., Louie, A. V., & Desautels, D. (2020). Factors associated with endocrine therapy adherence among post-menopausal women treated for early-stage breast cancer in Ontario, Canada. Breast cancer research and treatment, 179, 217-227.

Buck, H. G., Dickson, V. V., Fida, R., Riegel, B., D’Agostino, F., Alvaro, R., & Vellone, E. (2015). Predictors of hospitalization and quality of life in heart failure: A model of comorbidity, self-efficacy and self-care. International Journal of Nursing Studies, 52(11), 1714-1722.

Buck, H. G., Hupcey, J., Juárez-Vela, R., Vellone, E., & Riegel, B. (2019). Heart failure care dyadic typology: initial conceptualization, advances in thinking, and future directions of a clinically relevant classification system. The Journal of cardiovascular nursing, 34(2), 159.

Buck, H. G., Kitko, L., & Hupcey, J. E. (2013). Dyadic heart failure care types: qualitative evidence for a novel typology. J Cardiovasc Nurs, 28(6), E37-46. https://doi.org/10.1097/JCN.0b013e31827fcc4c

Buck, H. G., Stromberg, A., Chung, M. L., Donovan, K. A., Harkness, K., Howard, A. M., Kato, N., Polo, R., & Evangelista, L. S. (2018). A systematic review of heart failure dyadic self-care interventions focusing on intervention components, contexts, and outcomes. International Journal of Nursing Studies, 77, 232-242.

Buck, H. G., Zambroski, C. H., & Hupcey, J. E. (2013). Assessing the response of patients and spousal/partner caregivers to a new instrument measuring dyadic heart failure care types. European Journal of Cardiovascular Nursing, 12(2), 209-213.

Bugajski, A., Buck, H., Zeffiro, V., Morgan, H., Szalacha, L., Alvaro, R., & Vellone, E. (2021). The influence of dyadic congruence and satisfaction with dyadic type on patient self-care in heart failure. European Journal of Cardiovascular Nursing, 20(3), 268-275.

Castro, A. R., Arnaert, A., Moffatt, K., Kildea, J., Bitzas, V., & Tsimicalis, A. (2023). “Informal caregiver” in nursing: An evolutionary concept analysis. Advances in Nursing Science, 46(1), E29-E42.

Chin, C. H., Tseng, L. M., Chao, T. C., Wang, T. J., Wu, S. F., & Liang, S. Y. (2021). Self-care as a mediator between symptom-management self-efficacy and quality of life in women with breast cancer. PLoS One, 16(2), e0246430. https://doi.org/10.1371/journal.pone.0246430

Clari, M., Matarese, M., Ivziku, D., & De Marinis, M. G. (2017). Self-Care of People with Chronic Obstructive Pulmonary Disease: A Meta-Synthesis. Patient, 10(4), 407-427. https://doi.org/10.1007/s40271-017-0218-z

Clarke, J. L., Bourn, S., Skoufalos, A., Beck, E. H., & Castillo, D. J. (2017). An innovative approach to health care delivery for patients with chronic conditions. Population health management, 20(1), 23-30.

Cocchieri, A., Riegel, B., D’Agostino, F., Rocco, G., Fida, R., Alvaro, R., & Vellone, E. (2015). Describing self-care in Italian adults with heart failure and identifying determinants of poor self-care. European Journal of Cardiovascular Nursing, 14(2), 126-136.

Cohen, C. A., Colantonio, A., & Vernich, L. (2002). Positive aspects of caregiving: rounding out the caregiver experience. International journal of geriatric psychiatry, 17(2), 184-188.

Cohen, J. (1998). Statistical Power Analysis for the Behavioral Sciences. Routledge.

Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety, 18(2), 76-82. https://doi.org/10.1002/da.10113

Corter, A. L., Broom, R., Porter, D., Harvey, V., & Findlay, M. (2018). Predicting nonadherence to adjuvant endocrine therapy in women with early stage breast cancer. Psycho‐oncology, 27(9), 2096-2103.

De Maria, M., Erba, I., Ferro, F., Ausili, D., Matarese, M., & Vellone, E. (2023). The influence of dyad sex combination on patient self‐care and caregiver contribution to self‐care in multiple chronic conditions: An observational study. Journal of Nursing Scholarship.

De Maria, M., Ferro, F., Vellone, E., Ausili, D., Luciani, M., & Matarese, M. (2022). Self‐care of patients with multiple chronic conditions and their caregivers during the COVID‐19 pandemic: A qualitative descriptive study. Journal of Advanced Nursing, 78(5), 1431-1447.

De Maria, M., Iovino, P., Lorini, S., Ausili, D., Matarese, M., & Vellone, E. (2021). Development and Psychometric Testing of the Caregiver Self-Efficacy in Contributing to Patient Self-Care Scale. Value Health, 24(10), 1407-1415. https://doi.org/10.1016/j.jval.2021.05.003

De Maria, M., Vellone, E., Ausili, D., Alvaro, R., Di Mauro, S., Piredda, M., De Marinis, M., & Matarese, M. (2019). Self‐care of patient and caregiver DyAds in multiple chronic conditions: A LongITudinal studY (SODALITY) protocol. Journal of Advanced Nursing, 75(2), 461-471.

Di Nitto, M., Durante, A., Torino, F., Bolgeo, T., Damico, V., Ghizzardi, G., Zerulo, S. R., Alvaro, R., Vellone, E., & Biagioli, V. (2025). Validity and Reliability of the Self-Care of Chronic Illness Inventory and Self-Care Self-Efficacy Scale in Patients Living With Cancer. J Adv Nurs. https://doi.org/10.1111/jan.16823

Di Nitto, M., Lacarbonara, F., Bolgeo, T., Damico, V., Ghizzardi, G., Zerulo, S. R., Alvaro, R., Torino, F., & Vellone, E. (2025). Psychometric properties of the caregiver contribution to self-care of oral anticancer agents index: Longitudinal study. Research in Social and Administrative Pharmacy, 21(5), 351-360.

Di Nitto, M., Sollazzo, F., Biagioli, V., Torino, F., Alvaro, R., Vellone, E., & Durante, A. (2022). Self-care behaviours in older adults treated with oral anticancer agents: A qualitative descriptive study. Eur J Oncol Nurs, 58, 102139. https://doi.org/10.1016/j.ejon.2022.102139

Di Nitto, M., Ucciero, S., Bolgeo, T., Damico, V., Ghizzardi, G., Zerulo, S. R., Roselli, M., Alvaro, R., Torino, F., & Vellone, E. (2025). Psychometric Properties of the Self Care Oral Anticancer Agents Index (SCOAAI). Semin Oncol Nurs, 41(2), 151810. https://doi.org/10.1016/j.soncn.2025.151810

Dickson, V. V., Buck, H., & Riegel, B. (2011). A qualitative meta-analysis of heart failure self-care practices among individuals with multiple comorbid conditions. Journal of cardiac failure, 17(5), 413-419.

Durante, A., Ahtisham, Y., Cuoco, A., Boyne, J., Brawner, B., Juarez‐Vela, R., & Vellone, E. (2022). Informal caregivers of people with heart failure and resilience: A convergent mixed methods study. Journal of Advanced Nursing, 78(1), 264-275.

Eek, D., Krohe, M., Mazar, I., Horsfield, A., Pompilus, F., Friebe, R., & Shields, A. L. (2016). Patient-reported preferences for oral versus intravenous administration for the treatment of cancer: a review of the literature. Patient Prefer Adherence, 10, 1609-1621. https://doi.org/10.2147/ppa.S106629

Egede, L. E., Ellis, C., & Grubaugh, A. L. (2009). The effect of depression on self-care behaviors and quality of care in a national sample of adults with diabetes. General hospital psychiatry, 31(5), 422-427.

Ehrich, J., Mornane, A., & Powern, T. (2017). Psychometric Validation of the 10-item Connor-Davidson Resilience Scale. J Appl Meas, 18(2), 122-136.

Elkefi, S., & Asan, O. (2023). The Impact of Patient-Centered Care on Cancer Patients' QOC, Self-Efficacy, and Trust Towards Doctors: Analysis of a National Survey. J Patient Exp, 10, 23743735231151533. https://doi.org/10.1177/23743735231151533

Epstein, R. M., & Street, R. L., Jr. (2011). The values and value of patient-centered care. Ann Fam Med, 9(2), 100-103. https://doi.org/10.1370/afm.1239

Freedland, K. E., Skala, J. A., Steinmeyer, B. C., Carney, R. M., & Rich, M. W. (2021). Effects of depression on heart failure self-care. Journal of cardiac failure, 27(5), 522-532.

Gandek, B., Ware, J. E., Aaronson, N. K., Apolone, G., Bjorner, J. B., Brazier, J. E., Bullinger, M., Kaasa, S., Leplege, A., Prieto, L., & Sullivan, M. (1998). Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol, 51(11), 1171-1178. https://doi.org/10.1016/s0895-4356(98)00109-7

Gao, J., Wang, J., Zheng, P., Haardörfer, R., Kegler, M. C., Zhu, Y., & Fu, H. (2013). Effects of self-care, self-efficacy, social support on glycemic control in adults with type 2 diabetes. BMC Family Practice, 14(1), 66. https://doi.org/10.1186/1471-2296-14-66

Given, B. A., Spoelstra, S. L., & Grant, M. (2011). The Challenges of Oral Agents as Antineoplastic Treatments. Seminars in Oncology Nursing, 27(2), 93-103. https://doi.org/https://doi.org/10.1016/j.soncn.2011.02.003

Greer, J. A., Amoyal, N., Nisotel, L., Fishbein, J. N., MacDonald, J., Stagl, J., Lennes, I., Temel, J. S., Safren, S. A., & Pirl, W. F. (2016). A Systematic Review of Adherence to Oral Antineoplastic Therapies. Oncologist, 21(3), 354-376. https://doi.org/10.1634/theoncologist.2015-0405

Hooker, S. A., Schmiege, S. J., Trivedi, R. B., Amoyal, N. R., & Bekelman, D. B. (2018). Mutuality and heart failure self-care in patients and their informal caregivers. European Journal of Cardiovascular Nursing, 17(2), 102-113.

Iacorossi, L., Gambalunga, F., Fabi, A., Giannarelli, D., Facchinetti, G., Piredda, M., & De Marinis, M. G. (2016). Adherence to hormone therapy in women with breast cancer: a quantitative study. Professioni infermieristiche, 69(2).

Iovino, P., Lyons, K. S., De Maria, M., Vellone, E., Ausili, D., Lee, C. S., Riegel, B., & Matarese, M. (2021). Patient and caregiver contributions to self-care in multiple chronic conditions: a multilevel modelling analysis. International Journal of Nursing Studies, 116, 103574.

Iovino, P., Nolan, A., De Maria, M., Ausili, D., Matarese, M., Vellone, E., & Riegel, B. (2023). The influence of social support on self-care is mediated by self-efficacy and depression in chronic illness: key findings from the 'SODALITY' observational study. Aging Ment Health, 27(4), 820-828. https://doi.org/10.1080/13607863.2022.2056877

Jacobs, J. M., Ream, M. E., Pensak, N., Nisotel, L. E., Fishbein, J. N., MacDonald, J. J., Buzaglo, J., Lennes, I. T., Safren, S. A., Pirl, W. F., Temel, J. S., & Greer, J. A. (2019). Patient Experiences With Oral Chemotherapy: Adherence, Symptoms, and Quality of Life. J Natl Compr Canc Netw, 17(3), 221-228. https://doi.org/10.6004/jnccn.2018.7098

JASP Team. (2025). JASP (Version 0.19.3)[Computer software]. https://jasp-stats.org/

Jonkman, N. H., Westland, H., Groenwold, R. H., Ågren, S., Atienza, F., Blue, L., Bruggink-André de la Porte, P. W., DeWalt, D. A., Hebert, P. L., & Heisler, M. (2016). Do self-management interventions work in patients with heart failure? An individual patient data meta-analysis. Circulation, 133(12), 1189-1198.

Jovicic, A., Holroyd-Leduc, J. M., & Straus, S. E. (2006). Effects of self-management intervention on health outcomes of patients with heart failure: a systematic review of randomized controlled trials. BMC cardiovascular disorders, 6(1), 1-8.

Juarez, L. D., Presley, C. A., Howell, C. R., Agne, A. A., & Cherrington, A. L. (2021). The Mediating Role of Self-Efficacy in the Association Between Diabetes Education and Support and Self-Care Management. Health Education & Behavior, 49(4), 689-696. https://doi.org/10.1177/10901981211008819

Kueh, Y. C., Morris, T., Borkoles, E., & Shee, H. (2015). Modelling of diabetes knowledge, attitudes, self-management, and quality of life: a cross-sectional study with an Australian sample. Health and quality of life outcomes, 13(1), 1-11.

Lacarbonara, F., Di Nitto, M., Biagioli, V., Durante, A., Sollazzo, F., Torino, F., Roselli, M., Alvaro, R., & Vellone, E. (2023). Development and Content Validity of the Self-Care of Oral Anticancer Agents Index (SCOAAI). Semin Oncol Nurs, 39(3), 151402. https://doi.org/10.1016/j.soncn.2023.151402

Leong, C., Czaykowski, P., Geirnaert, M., Katz, A., Dragan, R., Yogendran, M., & Raymond, C. (2021). Outpatient oral anticancer agent utilization and costs in Manitoba from 2003 to 2016: a population-based study. Can J Public Health, 112(3), 530-540. https://doi.org/10.17269/s41997-020-00464-6

Li, C.-L., Chiu, Y.-C., Bai, Y.-B., Lin, J.-D., Stanaway, F., & Chang, H.-Y. (2017). The co-occurrence of depressive symptoms and cognitive impairment and its relationship with self-care behaviors among community dwelling older adults with diabetes. Diabetes Research and Clinical Practice, 129, 73-78.

Lou, V. W., Lau, B. H., & Cheung, K. S. (2015). Positive aspects of caregiving (PAC): scale validation among Chinese dementia caregivers (CG). Arch Gerontol Geriatr, 60(2), 299-306. https://doi.org/10.1016/j.archger.2014.10.019

Marzorati, C., Monzani, D., Mazzocco, K., Pavan, F., Monturano, M., & Pravettoni, G. (2019). Dimensionality and Measurement Invariance of the Italian Version of the EORTC QLQ-C30 in Postoperative Lung Cancer Patients [Original Research]. Frontiers in Psychology, 10. https://doi.org/10.3389/fpsyg.2019.02147

Novak, M., & Guest, C. (1989). Application of a multidimensional caregiver burden inventory. Gerontologist, 29(6), 798-803. https://doi.org/10.1093/geront/29.6.798

Oke, O., Niu, J., Chavez-MacGregor, M., Zhao, H., & Giordano, S. H. (2018). Adjuvant tamoxifen adherence in men with early stage breast cancer. In: American Society of Clinical Oncology.

Pucciarelli, G., Buck, H. G., Barbaranelli, C., Savini, S., Simeone, S., Juarez-Vela, R., Alvaro, R., & Vellone, E. (2016). Psychometric Characteristics of the Mutuality Scale in Stroke Patients and Caregivers. Gerontologist, 56(5), e89-98. https://doi.org/10.1093/geront/gnw083

R Core Team. (2025). R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing. https://www.R-project.org/

Riegel, B., Jaarsma, T., & Strömberg, A. (2012a). A middle-range theory of self-care of chronic illness. Advances in Nursing Science, 35(3), 194-204.

Riegel, B., Jaarsma, T., & Strömberg, A. (2012b). A Middle-Range Theory of Self-Care of Chronic Illness. Advances in Nursing Science, 35(3). https://journals.lww.com/advancesinnursingscience/Fulltext/2012/07000/A_Middle_Range_Theory_of_Self_Care_of_Chronic.3.aspx

Riegel, B., Lee, C. S., & Dickson, V. V. (2011). Self care in patients with chronic heart failure. Nature reviews cardiology, 8(11), 644-654.

Riegel, B., Lee, C. S., Ratcliffe, S. J., De Geest, S., Potashnik, S., Patey, M., Sayers, S. L., Goldberg, L. R., & Weintraub, W. S. (2012). Predictors of objectively measured medication nonadherence in adults with heart failure. Circulation: Heart Failure, 5(4), 430-436.

Riegel, B., Westland, H., Iovino, P., Barelds, I., Slot, J. B., Stawnychy, M. A., Osokpo, O., Tarbi, E., Trappenburg, J. C., & Vellone, E. (2021). Characteristics of self-care interventions for patients with a chronic condition: A scoping review. International Journal of Nursing Studies, 116, 103713.

Røen, I., Stifoss-Hanssen, H., Grande, G., Brenne, A.-T., Kaasa, S., Sand, K., & Knudsen, A. K. (2018). Resilience for family carers of advanced cancer patients—how can health care providers contribute? A qualitative interview study with carers. Palliative medicine, 32(8), 1410-1418.

Ryan, B. L., Brown, J. B., Tremblay, P. F., & Stewart, M. (2019). Measuring Patients' Perceptions of Health Care Encounters: Examining the Factor Structure of the Revised Patient Perception of Patient-Centeredness (PPPC-R) Questionnaire. J Patient Cent Res Rev, 6(3), 192-202. https://doi.org/10.17294/2330-0698.1696

Sangha, O., Stucki, G., Liang, M. H., Fossel, A. H., & Katz, J. N. (2003). The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum, 49(2), 156-163. https://doi.org/10.1002/art.10993

Sollazzo, F., Di Nitto, M., Rosito, L., Torino, F., Alvaro, R., Lacarbonara, F., Vellone, E., & Durante, A. (2023). Caregivers' contribution to self-care for patients treated with oral anticancer agents: A qualitative descriptive study. Eur J Oncol Nurs, 64, 102327. https://doi.org/10.1016/j.ejon.2023.102327

Świątoniowska-Lonc, N., Polański, J., Tański, W., & Jankowska-Polańska, B. (2021). Impact of cognitive impairment on adherence to treatment and self-care in patients with type 2 diabetes mellitus. Diabetes, Metabolic Syndrome and Obesity, 193-203.

Tan, F. C. J. H., Oka, P., Dambha-Miller, H., & Tan, N. C. (2021). The association between self-efficacy and self-care in essential hypertension: a systematic review. BMC Family Practice, 22(1), 44. https://doi.org/10.1186/s12875-021-01391-2

Tarlow, B. J., Wisniewski, S. R., Belle, S. H., Rubert, M., Ory, M. G., & Gallagher-Thompson, D. (2004). Positive aspects of caregiving: Contributions of the REACH project to the development of new measures for Alzheimer’s caregiving. Research on aging, 26(4), 429-453.

Tinari, N., Fanizza, C., Romero, M., Gambale, E., Moscetti, L., Vaccaro, A., Seminara, P., Longo, F., Gori, S., & Vici, P. (2015). Identification of subgroups of early breast cancer patients at high risk of nonadherence to adjuvant hormone therapy: results of an Italian survey. Clinical breast cancer, 15(2), e131-e137.

Vellone, E., Biagioli, V., Durante, A., Buck, H. G., Iovino, P., Tomietto, M., Colaceci, S., Alvaro, R., & Petruzzo, A. (2020). The influence of caregiver preparedness on caregiver contributions to self-care in heart failure and the mediating role of caregiver confidence. Journal of Cardiovascular Nursing, 35(3), 243-252.

Vellone, E., Chung, M. L., Alvaro, R., Paturzo, M., & Dellafiore, F. (2018). The influence of mutuality on self-care in heart failure patients and caregivers: a dyadic analysis. Journal of family nursing, 24(4), 563-584.

Vellone, E., Chung, M. L., Cocchieri, A., Rocco, G., Alvaro, R., & Riegel, B. (2014). Effects of self-care on quality of life in adults with heart failure and their spousal caregivers: testing dyadic dynamics using the actor–partner interdependence model. Journal of family nursing, 20(1), 120-141.

Vellone, E., D’Agostino, F., Buck, H. G., Fida, R., Spatola, C. F., Petruzzo, A., Alvaro, R., & Riegel, B. (2015). The key role of caregiver confidence in the caregiver’s contribution to self-care in adults with heart failure. European Journal of Cardiovascular Nursing, 14(5), 372-381.

Vellone, E., De Maria, M., Iovino, P., Barbaranelli, C., Zeffiro, V., Pucciarelli, G., Durante, A., Alvaro, R., & Riegel, B. (2020). The Self-Care of Heart Failure Index version 7.2: Further psychometric testing. Research in Nursing & Health, 43(6), 640-650. https://doi.org/https://doi.org/10.1002/nur.22083

Vellone, E., Fida, R., D’Agostino, F., Mottola, A., Juarez-Vela, R., Alvaro, R., & Riegel, B. (2015). Self-care confidence may be the key: a cross-sectional study on the association between cognition and self-care behaviors in adults with heart failure. International Journal of Nursing Studies, 52(11), 1705-1713.

Vellone, E., Fida, R., Ghezzi, V., D’agostino, F., Biagioli, V., Paturzo, M., Strömberg, A., Alvaro, R., & Jaarsma, T. (2017). Patterns of self-care in adults with heart failure and their associations with sociodemographic and clinical characteristics, quality of life, and hospitalizations: a cluster analysis. Journal of Cardiovascular Nursing, 32(2), 180-189.

Vellone, E., Lorini, S., Ausili, D., Alvaro, R., Di Mauro, S., De Marinis, M. G., Matarese, M., & De Maria, M. (2020). Psychometric characteristics of the caregiver contribution to self-care of chronic illness inventory. J Adv Nurs, 76(9), 2434-2445. https://doi.org/10.1111/jan.14448

Vellone, E., Riegel, B., & Alvaro, R. (2019). A situation-specific theory of caregiver contributions to heart failure self-care. Journal of Cardiovascular Nursing, 34(2), 166-173.

Villa, G., Vellone, E., Sciara, S., Stievano, A., Proietti, M. G., Manara, D. F., Marzo, E., & Pantaleo, G. (2019). Two new tools for self‐care in ostomy patients and their informal caregivers: Psychosocial, clinical, and operative aspects. International Journal of Urological Nursing, 13(1), 23-30.

Yuan, C., Xie, Z., Bian, J., Huo, J., & Daily, K. (2020). Outcomes of primary endocrine therapy in elderly women with stage I–III breast cancer: a SEER database analysis. Breast cancer research and treatment, 180, 819-827.

Zahrina, A. K., Norsa'adah, B., Hassan, N. B., Norazwany, Y., Norhayati, M. I., Roslan, M. H., & Wan Nazuha, W. R. (2014). Adherence to capecitabine treatment and contributing factors among cancer patients in Malaysia. Asian Pacific Journal of Cancer Prevention, 15(21), 9225-9232.

Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52(1), 30-41. https://doi.org/10.1207/s15327752jpa5201_2

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Copyright (c) 2026 Marco Di Nitto, Silvia Ucciero, Francesco Torino, Federica Lacarbonara, Valentina Biagioli, Izabella Uchmanowicz, Angela Durante, Ercole Vellone

Interdisciplinary Journal of Nursing and Health (eISSN: 3103-537X) continues Infermieristica Journal (eISSN 2785-7018).