Caregiver Anxiety, Depression and Preparedness in Heart Failure: Baseline Data From a Participating Center of the Re–motivate Hf Study

Background Heart failure is a chronic and progressive condition requiring complex and continuous management. This burden affects not only patients but also their caregivers, who are often exposed to high psychological and physical stress, particularly when patients show poor self–care. Aim To describe levels of anxiety and depression and the degree of role preparedness among caregivers of patients with chronic heart failure and poor self–care. Methods This observational study included caregivers of patients followed at the Azienda Socio Sanitaria Territoriale (ASST) of Lodi and enrolled in the RE–MOTIVATE HF study, an ongoing, dyadic, multicenter, randomized controlled trial aimed at evaluating the effectiveness of remote motivational interviewing in improving self–care in patients with heart failure. At baseline, together with self–care, we also evaluated patient anxiety, (with the Hospital Anxiety and Depression Scale (HADS)) and caregiver preparedness (with the Caregiver Preparedness Scale (CPS)). Categorical variables were described using frequencies and percentages, while continuous variables were described using means, standard deviations, or ranges. The association between caregiver preparedness and anxiety and depression levels was explored using Spearman’s correlation. Results A total of 50 caregivers were included, with the majority being female (80%). Clinically relevant anxiety levels (HADS–A ≥11) were observed in 73.3% of caregivers, while 22.2% showed borderline values. Marked depressive symptoms (HADS–D ≥11) were present in 34.7% of caregivers, and 61.2% reported borderline depressive symptoms. The mean CPS score was 17.8 ± 7.4, with considerable variability (range, 0–31). A trend toward an inverse association between caregiver preparedness and depressive symptoms was observed (ρ = –0.26; p = 0.067). Conclusions Caregivers of patients with heart failure and poor self–care experience high levels of anxiety and a substantial depressive burden, despite a generally sufficient but heterogeneous level of role preparedness. These findings underscore the need for structured psychological, motivational and educational interventions targeting caregivers, designed to reduce emotional distress and enhance disease management.