Reasons for seeking acute care in chronic heart failure

Abstract

Background: Patients with chronic heart failure (CHF) have frequent episodes of exacerbation leading to recurrent hospitalization. Aims: To explore factors related to patients seeking care for worsening CHF. Methods: Eighty-eight patients diagnosed with a deteriorating CHF condition were interviewed. Data were analysed using content analysis. Results: Overall, 51 (58%) patients sought emergency care because of their symptoms while 37 (42%) were either sent by relatives or referred from outpatient clinics. Delay in seeking care was explained by 62 (71%) patients as a "wait and see" strategy, 9 (10%) were reluctant to use the health care system and 10 (11%) felt that it was futile to seek care. Fifty percent of the patients were uncertain about their current deteriorating status. Only 4 patients reported their symptoms to be related to heart failure. Conclusions: Although symptoms were the dominant reason for seeking emergency care, only a few patients related their symptoms to worsening CHF, which might be an important factor for not seeking emergency care earlier. Patient education programs should make efforts to improve understanding of symptom recognition.

Fatigue is a Prevalent and Severe Symptom Associated with Uncertainty and Sense of Coherence in Patients with Chronic Heart Failure

“…Recent studies reveal that patients with CHF reported, on average, between three and eight symptoms (Nordgren & Sörensen, 2003;Patel, et al, 2006). The most prevalent symptoms reported by the patients were, in addition to dyspnea and fatigue, dry mouth, diffi cult sleeping, bodily pain and loss of balance.…”

“…The most prevalent symptoms reported by the patients were, in addition to dyspnea and fatigue, dry mouth, diffi cult sleeping, bodily pain and loss of balance. Commonly reported psychological symptoms were diffi culty concentrating, anxiety and depressed mood (Bennett et al, 2000;Zambroski et al, 2005;Patel et al, 2006). Patients with end-stage heart failure had symptoms similar to those of cancer and frequently reported nausea, loss of appetite and constipation (Nordgren & Sörensen, 2003).…”

“…For example, patients experience uncertainty when symptoms fi rst occur or when they lack information about the symptoms or when they contemplate deterioration of their symptoms (Winters, 1999;Patel et al, 2006). Because fatigue is a dominating illness experience in patients with CHF, it may contribute to feelings of uncertainty.…”

Informal Caregivers’ Experiences and Needs When Caring for a Relative With Heart Failure

“…1,2,3 Patients often need complex care due to old age, cognitive decline, co-morbidities and polypharmacy. 4 The health care resources for these patients have been reported as not meeting the patients' needs.…”

Non–Symptom-Related Factors Contributing to Delay in Seeking Medical Care by Patients With Heart Failure: A Narrative Review

“…{{4739 Goff The only other study examining emotional factors and delay was qualitative. The study by Patel et al (2007) reported that among patients with a diagnosis of deteriorating HF, 11% seeking medical care because they felt that their situation was hopeless. For instance, they perceived that seeking treatment was useless because there is no cure for HF.…”