Abstract 9927: Insufficient Monitoring and Inaccurate Evaluation Characterize the Heart Failure Symptom Perception Process

Abstract

Perceiving symptoms is needed before one can respond to symptoms, but little is known about the difficulties experienced by patients with heart failure (HF) as they engage in the complex processes of symptom monitoring, awareness, and evaluation. Aim: To explore difficulties in symptom perception and describe the characteristics of patients who consistently perceive HF symptoms. Methods: Using a convergent mixed methods design, we enrolled a purposeful sample of 40 adults with an unplanned hospitalization for HF symptom exacerbation. Quantitative data were obtained from the electronic health record and the Self-Care of Heart Failure Index (SCHFI v 7.2, scale scores 0-100, higher score = better self-care). Qualitative data from 1:1 semi-structured interviews exploring the symptom perception process were analyzed using directed content analysis. For data integration, individual difficulties in the SCHFI symptom perception processes of monitoring, awareness, and evaluation were anchored on the qualitative data. Two groups with different symptom perception consistency were identified from interviews. Group differences were examined using independent T, Mann-Whitney, Chi 2 , and Fisher’s Exact tests. Results: The sample was 50% male, 45% non-white, mean age 62 years, and 75% NYHA III-IV. Most (72.5%) demonstrated adequate symptom perception (SCHFI score ≥70). The consistent symptom perception group (n=27, 67.5%) had no difficulties in symptom monitoring, awareness, and evaluation while the inconsistent group reported insufficient symptom monitoring and/or inaccurate symptom evaluation. The consistent group was more experienced with HF and visited the emergency department more frequently in the past year. There were no group differences in age, gender, race, NYHA class, and HF stage (Table 1). Conclusion: Symptom perception interventions may be particularly useful early in the HF trajectory to enhance symptom monitoring and evaluation abilities.