Caregivers’ contribution to the care of patients with heart failure: a review

Abstract

Background. Heart failure (HF) is a chronic syndrome affecting more than 64 million people worldwide. Effective HF management depends on consistent self-care, which is increasingly performed with the support of informal caregivers. Objectives. To review current evidence on caregivers’ contribution (CC) to HF management, including its theoretical foundations, determinants, impact on patient and caregiver outcomes, and implications for clinical nursing practice. Material and methods. A narrative review of peer-reviewed literature published between January 2014 and October 2025 was performed using PubMed, Scopus, and CINAHL. Search terms combined «heart failure», «caregiver», «caregiver contribution», «self-care», and «caregiver burden». Original studies, systematic reviews, theoretical articles, and current European Society of Cardiology guidelines were included. Results. Caregivers contribute to two complementary processes: self-care maintenance and self-care management. Higher CC is associated with better patient self-care, fewer hospitalisations, and improved quality of life. Caregiver confidence is the strongest determinant of CC. Caregiving is, however, frequently linked to elevated burden, anxiety, depression, sleep disturbance, and reduced quality of life. Multicomponent interventions, including psychoeducation, motivational interviewing, and dyadic approaches, can improve outcomes for both members of the dyad. Conclusions. Caregivers are an indispensable extension of the formal HF care team. Nurses should systematically assess caregivers’ skills, confidence, and burden, and integrate them as partners in care planning.