Care-seeking delay of patients with heart failure in China: a mixed-method study
Mengqi Xu1,2, Tiantian Ruan3, Xiaoli Huang4
1Department of Nursing, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Care-seeking delay in heart failure (HF) patients in China averaged 7.5 days, influenced by symptom burden, depression, and pandemic-related factors. Addressing these can improve timely treatment for HF patients.
Area of Science:
- Cardiology and Public Health
- Health Services Research
Background:
- Heart failure (HF) poses a significant health burden in China.
- Timely care-seeking is crucial for effective heart failure management.
- Understanding care-seeking delays is essential for improving patient outcomes.
Purpose of the Study:
- To investigate the duration of care-seeking delay in Chinese heart failure patients.
- To identify factors influencing care-seeking delay among heart failure patients in China.
Main Methods:
- A convergent mixed-method design integrating cross-sectional and qualitative studies.
- Recruited 258 heart failure patients and healthcare professionals from general and community hospitals.
- Followed STROBE and COREQ guidelines for study conduct and reporting.
Main Results:
- The median care-seeking delay for heart failure patients was 7.5 days.
- Prolonged delay was associated with higher oedema symptom burden, higher depression scores, and lower dyspnoea symptom burden.
- Factors like the COVID-19 pandemic, medical system support, and caregiver abilities also influenced delay duration.
Conclusions:
- Care-seeking delay among heart failure patients in China requires significant attention.
- Symptom burden (dyspnoea, oedema), depression, pandemic context, medical support, and caregiver skills are key influencing factors.
- Interventions targeting these factors may reduce heart failure care-seeking delays.
Aim:
This study aims to explore the duration and influencing factors of care-seeking delay among patients with heart failure (HF) in China.
Methods And Results:
A convergent mixed method containing a cross-sectional study and two parts of qualitative studies was designed, following the STROBE and COREQ guidelines. Convenience sampling was applied to recruit patients with HF from two general hospitals from December 2021 to December 2022. Purposive sampling was used to enrol healthcare professionals from two general hospitals and two community hospitals from June to November 2022. Among the 258 patients with HF in the cross-sectional study, the median duration of care-seeking delay was 7.5 days. The result integration indicated that the delay duration was influenced by the dyspnoea symptom burden, the oedema symptom burden, and the depression status. The lower dyspnoea symptom burden, the higher oedema symptom burden, and the higher depression score were related to the prolonged care-seeking delay duration. The duration was also affected by the COVID-19 pandemic, level of support from medical system, and the symptom management abilities of the caregivers. The COVID-19 pandemic, low level of support from medical system, and limited symptom management abilities of caregivers were related to the prolonged care-seeking delay duration.
Conclusions:
Care-seeking delay among patients with HF needs attention in China. The duration of care-seeking delay of patients with HF was influenced by the dyspnoea symptom burden, the oedema symptom burden, and depression status, as well as the COVID-19 pandemic, level of support from medical system, and the symptom management abilities of the caregivers.
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