Excessive Caregiving Burden in Caregivers of Individuals with Heart Failure: Concept Analysis and Diagnostic Refinement.

and to refine the NANDA-I diagnosis, Excessive caregiving burden.MethodsA concept analysis based on Walker and Avant's framework was conducted, supported by an integrative review of studies retrieved from PubMed, the Virtual Health Library, Web of Science, and Scopus. Fifty-eight studies were included that supported identification of essential attributes, antecedents, consequents, and empirical referents. Model and contrary cases were developed.ResultsSix essential attributes, 13 antecedents, 28 consequents, and 12 empirical referents were identified. The essential attributes reflected a multidimensional response with negative impacts across psychological, functional, social, physical, and financial domains, compromising the caregiver's quality of life. The consequents supported identification and refinement of defining characteristics, including anxiety, sadness, worry, distress, social isolation, neglect of self-care, sleep disturbances, and exhaustion. The antecedents comprised both modifiable and non-modifiable factors, with the most frequent being lack of emotional, psychosocial, and professional support; severity of heart failure; the patient's functional dependence; and prolonged caregiving duration. Twelve empirical referents were identified, with the Zarit Burden Inventory and the Dutch Objective Burden Inventory being the most frequently used.ConclusionThe study advances the understanding of excessive caregiving burden in caregivers of individuals with heart failure by clarifying its complex and multidimensional nature and refining its diagnostic components.Implications for nursing practiceThe refined diagnostic components may support nurses in the systematic assessment and identification of this human response, enabling the implementation of targeted, multidimensional interventions.