Abstract 19917: Symptom Clusters Predictive of Treatment Seeking Delay in Older Adults With Acute Decompensated Heart Failure
Introduction: Older heart failure (HF) patients have difficulty recognizing and correctly interpreting symptoms, which can lead to delay in seeking treatment. Although symptoms rarely occur in isolation in this population, most predictive models only examine single symptoms in relationship to delay. Research has identified symptom clusters in HF, but how these clusters are related to delay in seeking treatment has not been explicated.
Purpose: To determine if there are specific symptom clusters predictive of delay in older adults with HF and to further determine if age and gender differences exist in these cluster profiles.
Methods: Hospitalized HF patients from three sites in the northeast (n = 334) were enrolled in an exploratory, descriptive study. Data on demographics (age, gender, ethnicity, marital status, education), symptom perception (Heart Failure Somatic Awareness Scale, 12 HF symptoms, 0-3), and delay time (measured in days) were collected during hospitalization. Symptom clusters were determined by hierarchical agglomerative clustering techniques in SPSS 22. Chi square and ANOVA (post hoc LSD) analyses were used to compare differences in age and gender by three symptom cluster groups and hierarchical regression was used to determine if clusters were predictive of delay.
Results: The sample of 334 adults was predominately older (72.5 ± 12.4 years), female (52%), African American (58%), and married (47%) with most completing high school (49%). Mean delay time was 8 ± 19.5 days. Three clusters were found: 1. Cardiac symptom cluster (palpitations, chest pain, upset stomach, cough), 2. Shortness of breath cluster (SOB) (SOB, tired, orthopnea, paroxysmal nocturnal dyspnea, less activity due to SOB), 3. Edema cluster (swollen feet, tight shoes, weight gain). Significant differences were found in age (clusters1 and 2 older than cluster 3, p = .003) but not gender. Regression analysis indicated specific symptom clusters were not uniquely predictive of delay in seeking treatment.
Conclusions: Results suggest that significant age but not gender differences exist in the symptom experience of older HF patients. Therefore, nursing care should include complete assessment of and education about the unique symptom cluster profiles of older adults.
Author Disclosures: K.A. Sethares: None. B. Ayotte: None. C.Y. Jurgens: None.
- © 2016 by American Heart Association, Inc.