Heart failure (HF) patients need to perceive symptoms quickly, label them correctly, and manage them well if they want to avoid hospitalization. Little is known about why some are better at this than others.
Methods: The purpose of this descriptive study guided by the revised situation specific theory of heart failure self-care was to identify determinants of symptom perception in patients with HF. We enrolled 349 community-living adults with any type of HF from inpatient settings and outpatient clinics in four northeastern and southern cities in the US and via an online national clinical research registry, ResearchMatch.com. All participants completed the revised Self-Care of HF Index (SCHFI V7.1) with a new scale measuring Symptom Perception defined as HF specific symptom monitoring, detection, recognition, and interpretation (Cronbach’s alpha .82, standardized score 0-100, with higher scores indicating better symptom perception). After exploring potential sociodemographic, clinical, and theoretical determinants of symptom perception, multiple regression analysis with forward selection was used to identify determinants of HF symptom perception.
Results: The sample was predominantly male (69%, 62±13.8 years), white (77%), married (64%), and educated at a high school level or less (39%). The median duration of HF was 7 years, and the median number of comorbid conditions was 2. Younger age, longer duration of HF (more than 1 year), higher HF self-care maintenance (Cronbach’s alpha .70), and higher symptom perception confidence (Cronbach’s alpha .84) were significant determinants of HF symptom perception. These four factors explained 48.3% of the variance in symptom perception (p<.001).
Conclusions: Older patients and those newly diagnosed with evidence of poor treatment adherence or low self-care self-efficacy should be targeted for HF symptom perception Interventions.