Abstract 1432: Recognition of Shortness of Breath and Edema as Heart Failure Symptoms
Introduction: Family members (FM) are often involved in the recognition of symptoms in persons with heart failure (HF), yet little information exists on the congruence and interpretation of symptoms within the HF/FM dyad. This descriptive study examined the degree of congruence between HF patients and their FM on symptom recognition behaviors.
Methods: A sample of HF patients receiving home healthcare (HHC) and their designated FM (n=70 dyads) were recruited. Data were obtained from the HHC chart and separate interviews with the HF patient and FM. Dyads completed measures of frequency and severity of common HF symptoms measured on a 0 –10 scale (Heart Failure Symptom Survey; HFSS), and symptom severity scores were calculated. Recognition of SOB and edema as symptoms of HF and confidence in HF self-care ability were measured by the Self-care of Heart Failure Index (SCHFI). Data were analyzed for patient and FM congruence on symptoms, confidence and HF symptom recognition using Spearman’s Rho correlations, concordance correlation coefficient and descriptive statistics.
Results: HF patients were 71±9.6 years in age; 40% male; 41%African American and 68% NYHA class III. FM were 75% women, 80% living in the same household and 44% spouses. There was high symptom assessment congruence between the patient and FM on HFSS scores on the symptom of edema (Rho=.65, p=.0001); and, moderate symptom assessment congruence on SOB at rest (Rho=.42, p=.0001 and SOB with activity (Rho=.40, p=.001). SOB and edema were not recognized as symptoms of HF by 38.6% of patients and 25.7% of FM. Family member ratings of HF self-care confidence were higher (mean=66.8±18.3) than patients (mean=60.5±19.0).
Conclusion: Over 25% of HF/FM dyads did not recognize the visible symptoms of SOB and edema as symptoms of HF; although they were congruent on the frequency and severity of these symptoms. FM’s expressed greater confidence in HF self-care over patients indicating the need for further evaluation of confidence among dyads and how this affects HF outcomes. There is a knowledge gap between the recognition of common symptoms and the ability to attribute these to the diagnosis of HF. Further study of HF self-care confidence and symptom recognition and their relationship to outcomes is required.