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Why do elders delay responding to heart failure symptoms?
Corrine Y Jurgens1, Linda Hoke, Janet Byrnes
1School of Nursing, Stony Brook University, Stony Brook, NY 11794-8240, USA. corrine.jurgens@stonybrook.edu
Nursing Research
|July 18, 2009
Summary
Older adults with heart failure (HF) often delay seeking care due to inadequate symptom recognition and response. Contextual factors significantly impact how elders interpret and react to HF symptoms, leading to delayed treatment.
Area of Science:
- Gerontology
- Cardiology
- Health Psychology
Background:
- Elderly individuals with heart failure (HF) face high hospitalization rates due to symptom management challenges.
- Delayed response to HF symptoms is a key factor contributing to recurrent hospital admissions.
- Contextual elements, including past illness experiences and psychosocial factors, influence symptom interpretation and response.
Purpose of the Study:
- To explore contextual factors influencing symptom recognition and response in elders hospitalized for decompensated heart failure.
Main Methods:
- A mixed-methods approach was employed, integrating quantitative scales (HF Symptom Perception Scale, Specific Activity Scale, Response to Symptoms Questionnaire) with qualitative interviews.
- Data collection included participant interviews, chart reviews, and validated questionnaires for individuals aged 65 and older.
- Qualitative data from open-ended questions provided in-depth insights into the symptom experience and its context.
Main Results:
- The study included 77 participants (mean age 75.9 years), with 81% classified as NYHA class III/IV, indicating low functional performance.
- Dyspnea, dyspnea on exertion, and fatigue were the most reported symptoms.
- A significant delay in seeking care was observed, with symptom duration ranging widely (e.g., dyspnea up to 90 days), highlighting challenges in symptom perception and attribution.
Conclusions:
- The physical and cognitive-emotional responses to heart failure symptoms in this older adult sample were insufficient for prompt healthcare seeking.
- Interventions should address contextual factors to improve symptom recognition and timely response in elders with HF.
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