Abstract 14762: Determinants of Treatment Seeking Delay in Older Adults With Acute Decompensated Heart Failure
Background: Despite reports that persons with heart failure (HF) symptoms delay up to 7 days before seeking treatment, few studies have prospectively explored specific factors influencing treatment-seeking delay in this population. Objective: Guided by the Theory of Symptom Management, the purpose of this study was to explore how factors related to the symptom experience including perception, evaluation, and response of patients and others influence delay in seeking treatment for symptoms of acute decompensated HF.
Methods: Hospitalized patients who had HF for ≥3 months and a previous HF admission were enrolled into an exploratory, descriptive study. Data on demographics (environment, clinical characteristics), perception (Heart Failure Somatic Awareness Scale; number and severity of symptoms), evaluation (uncertainty, attribution, seriousness), response to symptoms (Modified Response to Symptoms Questionnaire; emotional, behavioral and response of others), and delay time (measured in hours) were collected by interview during hospitalization and analyzed using generalized linear modeling.
Results: The sample of 131 adults was predominately older (77 ± 11.3 years) men (55.7%). The median delay time was 60 hours (2.5 days) with a range of 1 to 336 hours (14 days). Only 34 (25.9%) sought care in <12 hours. Three variables were statistically significant determinants of long delay time_waiting to see if the symptoms would abate, receiving a passive response to symptoms from others, and living in a rural environment. These variables explained 13.9 % of the variance in delay time. Clinical characteristics were not significant predictors of delay.
Conclusions: The responses of patients (wait-and-see) and others (e.g. don’t worry) contributed to delay as did living in a rural environment. Evaluative characteristics of attribution and understanding were not significant determinants of delay suggesting that patient education alone will not effectively decrease delay. Interventions directed toward decision-making in response to symptoms and inclusion of family members in such discussions may be more effective.
- © 2013 by American Heart Association, Inc.