Self management, symptom monitoring and associated factors in people with heart failure living in the community
Received 17 June 2009; received in revised form 17 December 2009; accepted 22 December 2009. published online 21 January 2010. Corrected Proof
Abstract
Background
Regular symptom monitoring enables early detection and treatment of heart failure exacerbations, reducing preventable hospital admissions.
Aim
To determine the level of self management and frequency of symptom monitoring and factors associated in patients with moderate severity HF living in the community.
Methods
A correlation study of a convenience sample of patients recently admitted or enrolled in treatment for heart failure were interviewed twice, one month apart, on self management and the frequency of monitoring five key heart failure symptoms.
Results
Participants (n=63) had an age mean of 78.38years (SD 8.54years), and approximately half were male (57%) and married (56%). Daily monitoring occurred in 69.8% for peripheral oedema, 65% for weight and 41.3% for fatigue, 38.9% for dyspnea during normal activity and 28.6% for dyspnea at night or at rest. At baseline, better self management was predicted by more comorbid conditions (ß=−2.64) and stronger sense of coherence (ß=−0.24), and one month later, by the baseline self management score (ß=.65). The only predictor of symptom monitoring at one month was the frequency of monitoring at baseline (OR=9.18).
Conclusions
Neither self management nor symptom monitoring is ideal in people with HF. As these behaviours did not change with time, interventions are needed early in the illness course.