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 analysis

Abstract

Aims: To reveal the multi-trajectory of anxiety and depression in patients with HF (heart failure) and their caregivers within 3 months post-discharge and to illustrate the interconnections among these trajectories and dyadic burden components.

Methods and results: We recruited 248 pairs of patients with HF and caregivers from four tertiary hospitals in Tianjin, China. Data were collected at baseline, 2 weeks, 4 weeks, and 3 months post-discharge. Group-Based Trajectory Modelling (GBTM) was used to identify the trajectories, while network analysis was used to explore interconnections among these trajectories and dyadic burdens components. Expected Influence (EI) was utilized to identify core nodes within the network. Three co-joint trajectories were identified: mild disorder (27.4%), moderate disorder (58.9%), and severe disorder (13.7%), with significant demographic differences noted among groups. The five most core nodes in the network were personal burden (EI = 1.19), role burden (EI = 1.07), dyspnoea when lying down (EI = 0.83), daytime dyspnoea (EI = 0.38), and difficulty sleeping (EI = 0.36). The nodes most strongly associated with anxiety and depression trajectories included chest pain, fatigue, and dizziness. Sensitivity analysis affirmed the findings' robustness.

Conclusion: Anxiety and depression co-joint trajectories among patients with HF and caregivers showed heterogeneity, with core constructions identified for future intervention studies to reduce dyadic burdens and improve the adverse development of anxiety and depression.

Registration: ChiTR ChiCTR2400088241.

Keywords: Anxiety; Depression; Dyadic burdens; Group-Based Trajectory Modelling; Network analysis; heart failure.