The Prognostic Nutritional Index as a Lifeline for Cardiovascular Health in Individuals With Insomnia: A Prospective Cohort Study.

Chronic heart failure (CHF) is a progressive and debilitating condition that imposes profound limitations on patients’ physical capacity, including dyspnea, fatigue, and edema, while also elevating the risk of anxiety and depression, which collectively erode the quality of life (; ; ). Globally, CHF affects an estimated 1%–3% of the adult population, with a prevalence exceeding 56 million cases worldwide, a number that continues to rise (; ). The impact on families is equally severe. Family caregivers face intense daily caregiving demands, from medication management to emotional support and symptom monitoring, alongside persistent psychological strain and an accumulating financial burden (; ; ). Over time, this sustained caregiving load compromises caregivers’ physical and mental health, disrupts family functioning, and undermines overall household well-being (; ). Coping, defined as cognitive and behavioral efforts to manage stressors that exceed personal resources (), can be meaningfully extended to the family level. Family coping refers to the coordinated processes through which a family system collectively navigates major stressors, maintains functional integrity, and supports members’ well-being (; ; ). These processes are uniquely demanding for families managing CHF. Families of patients with CHF require simultaneous attention to complex treatment regimens and emotional regulation to preserve homeostasis (; ). Consequently, effective family coping is not merely beneficial but essential for CHF management; when coping falters, patient outcomes worsen, caregiver burnout escalates, and a self-reinforcing cycle of deteriorating disease management and family distress may take hold (). Based on the trichotomy of coping strategies proposed by Weiten and our team’s preliminary research, family coping of patients with CHF comprises management strategies, psychological coping, family members’ support, emergency coping, heart failure awareness, and patients’ health behavior (; ). Family coping in patients with CHF may exhibit significant differences in the specific manifestations of diverse components of family coping. It has been evidenced that family coping profiles of patients with CHF are distinct and characterized by heterogeneity, highlighting the critical need to understand these heterogeneous coping patterns to develop tailored interventions that address specific needs and ultimately improve patient and family outcomes.