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Advanced heart failure patients and family caregivers health and function: randomised controlled pilot trial of online dignity therapy
  1. Weiling Yang1,
  2. Xiaonan Zhang1,
  3. Yanting Li1,
  4. Qingyun Lv1,
  5. Xinxing Gao2,
  6. Mei Lin3 and
  7. Xiaoying Zang1
  1. 1 School of Nursing, Tianjin Medical University, Tianjin, China
  2. 2 Department of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, China
  3. 3 Department of Nursing, Tianjin Medical University General Hospital, Tianjin, China
  1. Correspondence to Mrs Mei Lin; linmeitianjin{at}; Dr Xiaoying Zang; xiaoyingzang{at}


Objectives This research investigated the effectiveness of the caregiver-mediated online dignity therapy in enhancing dyadic health and family function.

Methods Heart failure (HF) family dyads were recruited between May and December 2021 from a university-affiliated hospital in China. The dyads (N=70) were randomly allocated to the intervention group and the control group. We assessed patients’ outcomes (hope, well-being, Family APGAR Index and quality of life (QoL)) and their family caregivers’ outcomes (anxiety, depression and Family APGAR Index) at baseline (T0), 1 week (T1), 4 weeks (T2) and 8 weeks (T3) after discharge.

Results For patients, the difference over time was significant in QoL (p<0.001). The interaction effects were significant for hope (p<0.001), well-being (p<0.001), Family APGAR Index (p<0.001) and QoL (p=0.007). For family caregivers, a significant difference in depression (p=0.001) was found within groups. Meanwhile, the interaction effects were significant on anxiety (p=0.002) and depression (p=0.016).

Conclusions Caregiver-mediated online dignity therapy among patients with advanced HF had potential to enhance patient outcomes (level of hope, well-being, family function and QoL) and alleviate caregiver outcomes (anxiety, depression) at 4-week and 8-week follow-up. Thus, we provided scientific evidence for palliative care for advanced HF.

Trial registration number ChiCTR2100053758.

  • Heart failure
  • Quality of life
  • Spiritual care
  • Family management
  • End of life care
  • Nursing Home care

Data availability statement

Data are available upon reasonable request.

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  • WY and XZ are joint first authors.

  • Contributors XZ and ML conceived the presented idea. WY wrote the paper. YL collected data. XG and XZ contributed to interpretation of results. QL and ZX conducted statistical analyses. ML and XZ critically revised the manuscript and approved the final version for submission. XZ and ML were responsible for the overall content as guarantor.

  • Funding The study was funded by the National Natural Science Foundation of China (71904143 and 71974142), the Youth Program of Tianjin Nursing Association (tjhlky2022QN08) and Nursing Special Development Fund of Tianjin Medical University (2022XKZX-04).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.