Think of Your Heart First: Understanding Heart Failure Symptoms

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Dr. K Reeder, research assistant professor at Goldfarb School of Nursing at Barnes-Jewish College

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.

  1. 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.
  2. 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.
  3. 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, kreeder@bjc.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.

Outreach in Honduras

In June, through the Office of Nursing Research at Goldfarb School of Nursing, students and faculty members visited Honduras for two weeks.  The weeks were full of peer-to-peer teaching, working at a medical brigade and a little sightseeing.

Dr. Donna Taliaferro, Paul McKee, Jr. associate dean for research and professor, recounts some of the highlights from the trip.

The first week we were at the College in Santa Barbara in Honduras and the students delivered the HIV modules in Spanish…they were amazing! The modules given were based on a research study we held when visiting Cameroon last year. These modules will also be given on our visit to Swaziland this next year. 

The second week we were at the medical brigade up in the mountains in Atima. The students and faculty handled triage all week. Our students meant every patient that came through the gates – all in Spanish! The students took turns going out on outreach trips into the rural areas, to the special school and working in the OB clinic. All of our students handled each and every patient with respect and sought advice when needed.

We even got to witness one of our students save a teenager’s life. During a visit at the special school, a teen was stung by a bee. While the teen really only had swelling of the hand, our student decided that the teen needed to come back to our ER just to be checked out. Even though the teen had no difficulty in breathing, and only the swelling, our student thought better – and he was right. The teen ended up going into anaphylactic shock and would have died if not in our ER at the time where we could treat him immediately.

All of our students did amazing work…I couldn’t have been prouder.”

Learn more about Goldfarb School of Nursing at Barnes-Jewish College Office of Nursing Research by visiting www.barnesjewishcollege.edu/research.

To see photos from the Honduras visit, click here.

Community education program aims to reduce accident and injuries in children

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According to the Centers for Disease Control, unintentional injury is the leading cause of death in children under the age of 14. These injuries occur at home and in the community – and they are predictable, preventable and controllable. That’s … Continue reading