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Agreement between Heart Failure Patients and Their Primary Caregivers on Symptom Assessment
Hassan Sharifi1, Mohammad Ali Rezaei2, Nastaran Heydari Khayat1
1Department of Medical Surgical Nursing, School of Nursing, Iranshahr University of Medical Sciences, Iranshahr, Iran.
Insights
Heart failure patients and caregivers often disagree on symptom assessment, impacting care. Improving their shared understanding of symptoms like shortness of breath is crucial for reducing hospital readmissions.
Area of Science:
- Cardiology
- Patient Care
- Health Outcomes
Background:
- Heart failure (HF) readmission rates are a significant concern.
- Patient and caregiver (CG) involvement in symptom assessment is key to reducing readmissions.
- Limited data exists on the agreement between HF patients and their CGs regarding symptom assessment.
Purpose of the Study:
- To assess the agreement between heart failure patients and their caregivers in evaluating HF symptoms.
- To identify specific symptoms where agreement is high or low between HF patient-caregiver dyads.
Main Methods:
- A correlational design was employed, recruiting 100 HF patient-caregiver dyads.
- Data collected using a modified Heart Failure Symptom Survey (HFSS).
- Pearson and intra-class correlation coefficients (ICC) analyzed agreement, with significance set at P≤0.05.
Main Results:
- Shortness of breath (SOB) was the most frequent and severe symptom assessed similarly.
- Good agreement observed for extremity swelling (ICC=0.861), SOB at rest (ICC=0.775), SOB with activity (ICC=0.795), and depression (ICC=0.769).
- Agreement levels varied: 28.6% good, 50% moderate, and 21.4% poor among dyads.
Conclusions:
- Significant disagreement exists between HF patients and caregivers in symptom assessment.
- Enhancing dyad knowledge and skills in HF symptom evaluation is vital for discharge planning.
- Nurses should address patient-caregiver misunderstandings or inabilities in symptom assessment.
Background:
To decrease the readmission rate of heart failure (HF) patients, patients and their caregivers (CGs) should participate in symptoms assessment. This study aimed to assess the agreement between HF patients and their CGs on symptoms assessment.
Methods:
Using a correlational design, 100 HF patients with their CGs (100 dyads) were recruited from Department of Cardiology, Iranshahr, during August-December 2014. Data were collected using modified Heart Failure Symptom Survey (HFSS).Pearson and intra-class correlation coefficients (ICC) were used to analyze the degree of agreement within HF dyads, using SPSS16. The level of significance was set at 0.05.
Results:
The most frequent and severe symptom assessed equally by partners was shortness of breath (SOB). Dyads had a good agreement on assessment of extremity swelling (r=0.87, P≤0.01, ICC=0.861 CI: 0.798-0.901), SOB at rest (r=0.83, P≤0.01, ICC=0.775, CI: 0.680-0.845), SOB with activity (r=0.81, P≤0.01, ICC=0.795 CI: 0.711-0.858), and feeling depressed (r=0.77, P≤0.01, ICC=0.769, CI: 0.675-0.838). 28.6% of HF dyad had a good, 50% had a moderate, and 21.4 % had a poor agreement in assessment of HF symptoms.
Conclusion:
Most of the HF dyad members did not agree with each other on the assessment of symptoms. Knowledge, skills and ability of each dyad in HF symptoms assessment should be included in the patients' discharge planning and nurses must modify their misunderstanding or inability.
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