Abstract 17338: Effect of Symptom Awareness Training on Heart Failure Self-Care and Symptom Burden

Abstract

Symptom severity is associated with timely care-seeking among heart failure (HF) patients. Delay in responding to symptoms frequently results in escalating symptom severity by the time patients seek care. The study purpose was to test the effect of an interactive symptom training protocol on self-care, symptom burden and health provider contact. Method: Using a randomized controlled trial design, 46 HF patients were randomized to a symptom training protocol or usual HF education. All received a weight scale and self-care booklet. Intervention patients received interactive training on symptom recognition and use of a daily symptom graph. HF self-care was measured using the Self-Care of HF Index (SCHFI) at baseline, 3 and 6 months, higher scores indicate better self-care. HF symptom severity was measured with the HF Somatic Perception Scale (HFSPS). Scores range 0-90 with higher scores indicating higher symptom burden. Emergent calls to providers were documented by telephone interview at 1, 3 and 6 months. Self-care and symptom severity were analyzed with repeated measures ANOVA. Results: The sample mean age was 71.4 years, SD 10.9, 39% female, 87% White and functionally compromised (78% NYHA III-IV). Both groups had clinically relevant improvement in SCHFI maintenance and management scores at 3 months and some further improvement in maintenance scores at 6 months, but no significant differences between groups. Despite similar SCHFI scores at 6 months, the mean HFSPS score was 50% lower in the intervention group (10.6 vs 20.4, p=.03). The intervention group initiated more contacts with health providers than the usual care group (10 vs 8). Implications: Patients receiving symptom training demonstrated improvement in symptom recognition ability although self-care scores were no different than those of the control group. Better symptom recognition may be responsible for increased contact with health providers by those in the intervention group.