¶ … Elders Delay Responding to Heart Failure Symptoms? "Heart failure (HF) is the most common admission diagnosis in the United States for persons over 65 years of age, with readmission often occurring within 60 days of discharge… Part of the reason for repeated admissions is that patients delay responding to their HF symptoms" (Byrnes et al., 2009, p. 252-253).

"The specific aims of this study were to (a) describe the experience of and the cognitive and emotional response to the symptoms of decompensated HF, (b) determine the influence of sociodemographic, clinical, cognitive, emotional, and social contextual factors on symptom duration during this time, and (c) describe self-care behaviours prior to seeking care for decompensated HF" (Byrnes et al., 2009, p. 255).

Hypothesis

"We propose that delay in seeking care is due to the difficulty that HF patients experience in discerning the quality and meaning of their symptoms" (Byrnes et al., 2009, p. 255).

Study Methods

This study was conducted on a convenience sample of adult men and women who were hospitalized in Philadelphia and New York with a diagnosis of decompensated HF. The mean age of the sample was 75.9 years. 48% were female and 85.7% were non-Hispanic White.

Data for this study was gathered using the Heart Failure Somatic Perception Scale, the Response to Symptoms Questionnaire, the NYHA Functional Class and Specific Activity Scale, and the Charlson Comorbidity Index. Interviews were also conducted with each participant in order to determine length...

Each interview was recorded and transcribed in verbatim for analysis and comparative purposes.
Quantitative data was analyzed using the Statistical Package for the Social Sciences software version 14.0. Qualitative data was analyzed using Atlas.ti version 5.0.67. The connections between the duration of HF symptoms, perceptions of symptom distress, and cognitive and emotional factors were analyzed using Pearson correlations.

Key Findings

The most frequently reported HF symptoms were dyspnea, dyspnea on exertion, and fatigue. Close to half of all participants experiencing dyspnea waited three days or longer before seeking medical attention, while 11.8% waited two weeks or more.

The delay in seeking medical attention was attributed to inadequate symptom experience and cognitive and emotional response. Over half of the participants did not realize that their symptoms were associated with HF or did not realize how serious their symptoms were. Only 76.6% of participants experienced feelings of fear regarding their symptoms.

Byrnes, J., Hoke, L., Jurgens, C.Y., & Riegel, B. (2009). Why do elders delay responding to heart failure symptoms? Nursing Research, 58(4), 274-282.

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Problem Statement

"Diabetes is a significant chronic illness…