PATIENT PERCEPTIONS OF CONGESTIVE HEART FAILURE AND BARRIERS TO PHYSICAL ACTIVITY

Abstract

Congestive heart failure (CHF) afflicts around 5.8 million individuals in the U.S. and accounts for one million hospitalizations each year. Standard of care includes regular exercise to relieve symptoms and improve health-related quality of life (hrQOL) but fewer than 10% achieve currently recommended goals. This study aimed to understand patient and caregiver perceptions of CHF and understand patient and caregiver perceptions of challenges to engaging in physical activity (PA). Patients and family members were recruited from the Heart and Vascular Clinic at a university hospital to participate in focus groups discussing their perceptions and expectations of CHF treatment, particularly regarding PA. Transcribed audiotapes were coded and analyzed using a grounded theory framework. Questionnaires gathered information on social support for PA, illness perceptions of CHF and whether/where they remember being counseled in PA. Ten CHF patients and 6 supporting caregivers have completed the study to-date. Patients’ mean age was 72.8 years +/- SD 8.6 years. Themes arising from the focus groups included “insurmountable” fatigue preventing exercise, perseverance needed to exercise despite fatigue, frustration with inability to be as active as they were prior to symptom onset, “embarrassing” lifestyle changes such as utilizing electric scooters, acceptance of physical limitations required to improve outlook and fatalism about CHF-related death. The above themes identify a complex web of patient and caregiver perceptions and expectations that influences patient PA levels. Having a better understanding of perceived barriers in obtaining recommended PA levels will allow targeting of these perceptions in future interventions.