Factors Influencing Healthcare-Seeking Decisions Delay During Acute Exacerbations in Older Adults with Chronic Heart...

Older adults with chronic heart failure often experience significant delays in making healthcare-seeking decisions from the onset of symptom exacerbation to the final decision to seek medical care. Guided by the Health Belief Model and the Theory of Planned Behavior, this study investigates the duration and factors influencing delayed healthcare-seeking decisions following symptom acute exacerbations in older adults with chronic heart failure.

A cross-sectional study was conducted from November 2023 to June 2024, employed a convenience sampling method, involving 244 older adults with chronic heart failure hospitalized in two general hospitals in Nanjing, China. Data were collected using a questionnaire survey and all research instruments were validated and tested for reliability.

The results showed that the healthcare-seeking decisions time among the 244 patients ranged from 2 hours to 4410 hours, with a median time of 187.5 hours (7.8 days), Q1 of 82.0 hours, and Q3 of 504.5 hours. Regression analysis indicated that symptom management self-efficacy (β = 0.637, P < 0.001), social support (β = -0.195, P < 0.001), heart failure somatic perception (β = -0.159, P = 0.003), speed of onset (β = -0.119, P = 0.028), and attempts at self-management (β = 0.102, P = 0.031) were significantly associated with the delay in healthcare-seeking decisions.

This study revealed that healthcare-seeking decision delays are common among older adults with chronic heart failure in China, primarily influenced by factors such as heart failure somatic perception, social support, symptom management self-efficacy. The findings suggest that strengthening health education, improving social support networks, and optimizing multidisciplinary collaboration may help shorten decision-making time, thereby improving patients' clinical outcomes and quality of life.