Contribution of informal caregivers in the self-care of patients with coronary artery disease: a descriptive cross-sectional study

BACKGROUND: Cardiovascular diseases, particularly coronary artery disease (CAD), remain the leading cause of death worldwide. Family involvement in self-care is essential for improving health outcomes, especially where professional care is limited. This study aimed to assess the contribution of informal caregivers to the self-care of patients with CAD and to identify related factors. METHODS: This descriptive cross-sectional study was conducted in 2024 at Mousavi Hospital, Zanjan, Iran. A total of 250 patients with confirmed coronary artery disease (CAD) who were admitted to the cardiology ward or cardiac care unit (CCU), along with their 250 informal caregivers, were recruited using convenience sampling. Data were collected using a demographic questionnaire and the Caregiver Contribution to Self-Care of Coronary Heart Disease Inventory (CC-SC-CHDI v3a). Statistical analyses were performed using SPSS version 27, including descriptive statistics, independent t-tests, one-way ANOVA, and multivariable linear regression. RESULTS: The mean caregiver contribution scores were 71.63 ± 14.48 for self-care maintenance, 51.88 ± 19.75 for self-care monitoring, and 50.68 ± 23.59 for self-care management. Caregivers showed the highest involvement in maintenance, exceeding the desirable threshold of 70. Significant associations (P < 0.05) were found between caregiver contribution and several patient characteristics, including gender (P = 0.007), age (P = 0.003), number of children (P = 0.016), income level (P = 0.007), residence (P = 0.001), supplemental insurance coverage (P = 0.001), educational level (P = 0.001), and cardiac ejection fraction (P = 0.036). Patients who had received health education through online platforms were also more engaged in self-care (P = 0.014). In addition, caregivers with higher educational attainment (P = 0.004) demonstrated greater involvement in the maintenance domain. In the regression analysis, female patients had higher maintenance scores (B = 5.74, β = 0.20, P = 0.002, R² = 0.078). Longer illness duration predicted higher monitoring (B = 0.72, β = 0.18, P = 0.006, R² = 0.057) and management (B = 0.79, β = 0.17, P = 0.011, R² = 0.044) scores. Caregiving duration was a positive predictor for monitoring (B = 0.46, β = 0.17, P = 0.019), whereas number of children (B = - 2.43, β = - 0.21, P = 0.034) and being single (B = - 13.45, β = - 0.27, P = 0.003) were associated with lower caregiver contribution in management. CONCLUSION: Informal caregivers play a key role in maintaining the self-care of CAD patients, whereas their involvement in monitoring and management remains moderate. Demographic factors such as education, income, cohabitation, and caregiving duration significantly affect their contribution. Targeted caregiver education and support may enhance patient outcomes and reduce readmissions and improve long-term cardiac outcomes.