{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:52:53Z","timestamp":1781844773225,"version":"3.54.5"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the actor-partner interdependence mediation effect of efamily cohesion and adaptability on self-care ability in patients with chronic heart failure (CHF) and their spouses, mediated through symptom perception and caregiving contribution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey was conducted among 212 CHF inpatients and their spouses from Rugao Hospital of Traditional Chinese Medicine, Nantong. Core variables were assessed using: Family Adaptability and Cohesion Scale (FACES-II), Heart Failure Somatic Perception Scale (HFSPS), European Heart Failure Self-Care Behavior Scale for Caregivers (EHFScBS-C), Self-Care of Heart Failure Index (SCHFI). Actor-Partner Interdependence Mediation Model (APIMeM) was employed to analyze actor effects and partner effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The family function scores of CHF patients and their spouses were (102.36\u202f\u00b1\u202f18.24) and (98.75\u202f\u00b1\u202f16.83) respectively. The total score of HFSPS for patients was (52.71\u202f\u00b1\u202f12.38), and the total score of EHFScBS-C for spouses was (64.18\u202f\u00b1\u202f14.79). The total score of SCHFI for patients was (155.73\u202f\u00b1\u202f43.30), among which the management dimension was the weakest with a score of (48.67\u202f\u00b1\u202f13.76). In the subject effect analysis, the direct effect of family function on self-care ability accounted for 38.5%, the indirect path through symptom perception accounted for 35.3%, and the indirect path through care contribution accounted for 26.2%. In the object effect analysis, the direct effect of the spouse\u2019s family function on the patient\u2019s self-care ability accounted for 40.0%, the indirect path through the patient\u2019s symptom perception accounted for 32.3%, and the indirect path through the spouse\u2019s care contribution accounted for 27.7%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Family cohesion and adaptability are associated with lower levels of symptom burden and greater spousal care contributions, and are both linked to better self-care ability in patients with CHF. Clinical interventions should consider the patient-spouse dyad as a whole. By improving family adaptability and providing targeted support for spouses in managing daily behaviors, patient self-care ability can be enhanced.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1684435","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:28:52Z","timestamp":1781843332000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Family cohesion and adaptability in heart failure: an APIMeM analysis of symptom perception and spousal caregiving on patient self-care"],"prefix":"10.3389","volume":"13","author":[{"given":"Yan","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Rugao Hospital of Traditional Chinese Medicine","place":["Nantong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rugao Hospital of Traditional Chinese Medicine","place":["Nantong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rugao Hospital of Traditional Chinese Medicine","place":["Nantong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","article-title":"Global burden of heart failure: a comprehensive and updated review of\u202fepidemiology","volume":"118","author":"Savarese","year":"2023","journal-title":"Cardiovasc Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1186\/s12877-025-05959-w","article-title":"Trends and influencing factors of self-management in patients with chronic heart\u202ffailure: a longitudinal 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