APPLYING STRESS AND COPING THEORY TO UNDERSTAND DIURETIC ADHERENCE EXPERIENCES IN THOSE WITH HEART FAILURE

Abstract

Abstract Heart failure (HF) is a chronic and costly condition, affecting at least 6 million Americans. The ventricular dysfunction associated with HF results in fluid volume overload, which is commonly managed with diuretics. Despite the benefits of diuretics, some individuals with HF report bothersome and stressful side effects and intentionally do not adhere. Positive intrinsic motivators, such as positive emotions, may benefit individuals in their adaptation to medication-related stress. However, there has been limited study of these potential motivators in older adults with HF. The purpose of this descriptive qualitative study was to understand intrinsic factors underlying diuretic adherence in adults with HF using the transaction theory of stress and coping. Using a descriptive qualitative approach, 82 adults who were hospitalized for HF and prescribed home diuretics were interviewed. The findings of the current study revealed the ways participants appraised diuretics and how they overcame the perceived medication effects so they could adhere to the medication. Data analysis revealed three themes: (1) diuretics are bothersome (2) staying positive in the midst of hardship, and (3) adapting to endure. Adherent participants stayed positive amid the perceived medication-related hardship, maintaining resilient and grateful attitudes. Adherent participants adapted to bothersome diuretic effects and utilized creative strategies for adherence. More research is needed to understand the relationships between resilience, adaptive coping, and adherence to diuretics.