An estimated 5.1 million Americans have heart failure, a figure that is expected to increase 25 percent by 2030. Heart failure is a serious, chronic condition associated with frequent hospitalizations and a high rate of death.
Living with heart failure requires vigilance in self-management and monitoring, including early recognition, interpretation and reporting of symptoms. For many patients, taking care of their heart failure is challenging, as symptoms may be vague, may wax and wane over time, or may overlap with other conditions and medication side effects.
A study conducted by Dr. K. Reeder is aimed at helping patients manage heart failure, improve quality of life, and avoid hospitalization. Dr. Reeder is a nurse researcher at Goldfarb School of Nursing at Barnes-Jewish College in St. Louis, Missouri. In 2010, Dr. Reeder received a five-year grant from the National Institutes of Health (NIH) – National Institute of Nursing Research (NINR) to study how patients recognize, interpret, and manage heart failure symptoms. Descriptions of patients’ symptom experiences will enhance understanding of how patients perceive their symptoms and the self-care strategies they use to relieve their symptoms.
Findings from Dr. Reeder’s study indicate patients often fail to recognize and attribute signs and symptoms to their heart, even though all of the patients interviewed experienced at least one of the three most common symptoms leading to hospitalization: 1) shortness of breath, 2) fatigue, and 3) swelling or weight gain due to excess fluid retention. Patients participating in this study often reported that their symptoms were caused by a variety of things other than heart failure, such as changes in their diet or medications and other illnesses such as pneumonia or diabetes. One patient said, “I couldn’t walk to the mailbox without shortness of breath. I would sit and rest halfway to the mailbox, and then my shortness of breath would disappear. I never recognized it as my heart. I thought it was my lungs, probably pneumonia.”
Patients in this study also delayed reporting symptoms to a health care provider; some delaying for over two weeks or until symptoms were severe. One patient said, “I thought I had an upper respiratory infection and would get over it. I had shortness of breath approximately six weeks, but it got worse in the last two weeks. My friend took me to the emergency room.”
Other studies have found that early recognition and reporting of symptoms to health care providers is an important step in preventing hospitalizations, yet Dr. Reeder’s study showed that recognizing and interpreting symptoms related to heart failure may be difficult, leading to use of various self-care strategies and delayed reporting to health care providers.
If you are living with heart failure (or know someone who is living with heart failure), think of your heart firstsm when you feel changes in your health.
- Think of your heart firstsm if you have shortness of breath, fatigue, or swelling and weight gain, and report these symptoms to your health care provider.
- Even if you have other diseases or illnesses that could be causing your symptoms, think of your heart first when you have symptoms, as symptoms of other conditions are often related to your heart.
- Think of your heart firstsm by recognizing early signs and symptoms, and reporting them to your doctor. Be aware of signs and symptoms such as a cough that won’t go away, upset stomach, nausea, or lack of appetite, confusion or altered thinking and racing or throbbing heart.
For more information about this research, please contact Dr. K Reeder, Goldfarb School of Nursing at Barnes-Jewish College, 314-286-2654, firstname.lastname@example.org.
This project is supported by the National Institute of Nursing Research of the National Institutes of Health under award number R00NR012217. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, National Institute of Nursing Research.