2.50
Hdl Handle:
http://hdl.handle.net/10755/163125
Category:
Abstract
Type:
Presentation
Title:
Elders Lack Contextual Cues and Delay Response to Heart Failure Symptoms
Author(s):
Jurgens, Corrine Y.; Riegel, Barbara
Author Details:
Corrine Y. Jurgens, PhD, RN, CS, ANP, Stony Brook University, Stony Brook, New York, USA, email: corrine.jurgens@stonybrook.edu; Barbara Riegel, DNSc, RN, CS, FAAN, University of Pennsylvania
Abstract:
Purpose: Symptom monitoring is one aspect of self-care heart failure (HF) patients struggle with. Comorbid illness and advanced age, typical among HF patients, complicates determining the meaning of symptoms. Early decompensation symptoms (fatigue, dyspnea) may be attributed to less threatening illness or accepted as normal aging. Little is known about how context (physical, cognitive, emotional factors) affect perception and response to HF symptoms. The purpose of this study was to examine contextual factors in relation to symptom recognition and response among elders hospitalized with acute HF. Theoretical Framework: The Self-Regulation Model of Illness informed the study as it incorporates the physical symptom experience within the context in which it occurs. Methods (Design, Sample, Setting, Measures, Analysis): A mixed methods design was used. The HF Symptom Perception Scale (symptom distress), Response to Symptoms Questionnaire (contextual/emotional factors), and Specific Activity Scale (functional performance) were administered to subjects 65 years or older. Clinical details were collected by interview and chart review. Open-ended questions addressing the symptom experience were audio taped, transcribed and analyzed for themes. Results: The convenience sample (N = 75) was 47% female, 85% non Hispanic white, mean age 75.8 (SD 7.7). Functional performance was low (80% class III/IV). The most frequently reported symptoms were dyspnea, dyspnea on exertion, and fatigue. Median duration of early symptoms of HF decompensation was 5 to 7 days, but dyspnea duration ranged 30 minutes to 90 days before care-seeking. Lower anxiety and higher symptom distress were associated with longer dyspnea duration. Over half reported not knowing the symptoms of HF or their importance. Conclusions and Implications: Elders delayed responding to escalating HF symptoms. Lack of an emotional response and a cognitive context in which to interpret the meaning of symptoms contributes to poor symptom recognition and increases hospitalization risk for symptom management. Research is needed to understand if a physiologic basis underlies delayed symptom recognition.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
19th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Providence, Rhode Island, USA
Description:
Conference theme: Building Communities of Scholarship and Research, held April 12-14, 2007 at The Westin Providence.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleElders Lack Contextual Cues and Delay Response to Heart Failure Symptomsen_GB
dc.contributor.authorJurgens, Corrine Y.en_US
dc.contributor.authorRiegel, Barbaraen_US
dc.author.detailsCorrine Y. Jurgens, PhD, RN, CS, ANP, Stony Brook University, Stony Brook, New York, USA, email: corrine.jurgens@stonybrook.edu; Barbara Riegel, DNSc, RN, CS, FAAN, University of Pennsylvaniaen_US
dc.identifier.urihttp://hdl.handle.net/10755/163125-
dc.description.abstractPurpose: Symptom monitoring is one aspect of self-care heart failure (HF) patients struggle with. Comorbid illness and advanced age, typical among HF patients, complicates determining the meaning of symptoms. Early decompensation symptoms (fatigue, dyspnea) may be attributed to less threatening illness or accepted as normal aging. Little is known about how context (physical, cognitive, emotional factors) affect perception and response to HF symptoms. The purpose of this study was to examine contextual factors in relation to symptom recognition and response among elders hospitalized with acute HF. Theoretical Framework: The Self-Regulation Model of Illness informed the study as it incorporates the physical symptom experience within the context in which it occurs. Methods (Design, Sample, Setting, Measures, Analysis): A mixed methods design was used. The HF Symptom Perception Scale (symptom distress), Response to Symptoms Questionnaire (contextual/emotional factors), and Specific Activity Scale (functional performance) were administered to subjects 65 years or older. Clinical details were collected by interview and chart review. Open-ended questions addressing the symptom experience were audio taped, transcribed and analyzed for themes. Results: The convenience sample (N = 75) was 47% female, 85% non Hispanic white, mean age 75.8 (SD 7.7). Functional performance was low (80% class III/IV). The most frequently reported symptoms were dyspnea, dyspnea on exertion, and fatigue. Median duration of early symptoms of HF decompensation was 5 to 7 days, but dyspnea duration ranged 30 minutes to 90 days before care-seeking. Lower anxiety and higher symptom distress were associated with longer dyspnea duration. Over half reported not knowing the symptoms of HF or their importance. Conclusions and Implications: Elders delayed responding to escalating HF symptoms. Lack of an emotional response and a cognitive context in which to interpret the meaning of symptoms contributes to poor symptom recognition and increases hospitalization risk for symptom management. Research is needed to understand if a physiologic basis underlies delayed symptom recognition.en_GB
dc.date.available2011-10-27T11:01:45Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:01:45Z-
dc.conference.date2007en_US
dc.conference.name19th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationProvidence, Rhode Island, USAen_US
dc.descriptionConference theme: Building Communities of Scholarship and Research, held April 12-14, 2007 at The Westin Providence.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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