Well-being Program for Caregivers of Patients With Advanced Cardiac and Pulmonary Disease

Study Recruitment According to Research Team Records

Recruitment-success percentage in the study will be assessed based on research team study records.

Study Consent Rates According to Research Team Records

Consent-success percentage in the study and reasons for declining participation will be assessed based on research team study records.

Self-Reported Adherence to Multimodal Well-being Program According to Participant Logs (Intervention Group Only)

Program adherence will be monitored through participant-led tracking tools, periodic communications with the exercise professional, review of exercise and activity logs completed by participants (including exercise type, frequency, and perceived exertion), and use of Fitbit activity trackers (caregivers only). Adherence will be defined as the completion of at least ≥ 70% of the intervention components, including aerobic and resistance exercise, engagement with nutritional counselling, and participation in stress reduction strategies.

Safety Assessed Via Self-Reported Adverse Events

Safety will be assessed via self-reported adverse events documented in exercise logs and verified during weekly virtual check-ins. Participants will be explicitly instructed to report any adverse events immediately, even outside scheduled sessions, to ensure timely assessment and response by the research team

Health-Related Quality of Life Assessed by Short-Form 36 Questionnaire (All Caregivers and Patients)

Health-related Quality of Life (HRQL) will be assessed through the Short-Form 36 (SF-36) Questionnaire. This generic health instrument is widely employed and comprises 8 health domains and two summary scores (physical and mental) ranging from 0 to 100, with higher scores indicating better HRQL. It assesses quality of life and has normative values of 50, with a minimal important difference (MID) of 5 points.

Mood Assessed by Depression, Anxiety, and Stress Scale (All Caregivers and Patients)

The Depression, Anxiety and Stress Scale (DASS-21) questionnaire has 21 items to assess mood (anxiety, depression, and stress). Each statement is given a score of 0 (not applicable) to 3 (applicable most of the time), with a sub-score calculated for each domain as the sum of individual scores, ranging from 0-42 with higher scores indicating worse mood disturbances. Sub-scores are then categorized as follows: Normal, Mild, Moderate, Severe, and Extremely Severe.

Stress Assessed by Perceived Stress Scale (All Caregivers and Patients)

Stress will be assessed using the Perceived Stress Scale. This is a commonly used tool for assessing psychological stress, measuring the degree to which life situations are unpredictable or overwhelming. Scores range from 0 to 40, with higher scores indicating increased stress

Advanced Care Planning Assessed by Preparedness for Caregivers Scale (Caregiver Arms Only)

Caregiver readiness to handle the caregiving role will be assessed by the Preparedness for Caregivers Scale. This is a brief self-report tool used to assess how well informal caregivers feel prepared to provide care across multiple domains, including physical and emotional support, managing stress, and navigating healthcare systems. It consists of 8 items rated on a scale from 0 (not at all prepared) to 4 (very well prepared). The final score is the mean of all items answered, ranging from 0 to 4, with higher scores indicating greater perceived preparedness for caregiving.

Qualitative Interview (Optional)

A subset of caregiver and patient participants will be invited to participate in an optional qualitative semi-structured interview at flexible time points before, during, or up to approximately 4 weeks after the study period.