อาการและอาการแสดง การจัดการอาการด้วยตนเอง และการจัดการที่ห้องฉุกเฉินในผู้สูงอายุที่มีภาวะหัวใจล้มเหลว

Surasak  Mulsrisuk; Supreeda  Monkong; Nuchanad  Sutti

Authors

Surasak Mulsrisuk Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Supreeda Monkong Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University,
Nuchanad Sutti Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University,

Keywords:

signs and symptoms, congestive heart failure, older adults, self-management

Abstract

Objective: To examine older adults’ symptoms and signs of congestive heart failure and self-management behaviour, as well as the emergency department’s management of such older adults

Design: Descriptive research

Methodology: The subjects were 163 purposively sampled older adults with congestive heart failure treated in the emergency department of a tertiary care hospital from February to May 2021. The research instruments consisted of: 1) a demographic data questionnaire; 2) a questionnaire on the signs and symptoms of congestive heart failure in older adults and their self-management behaviour; and 3) the emergency department’s records of management of the older adults during their visits. The data were analysed using descriptive statistics, including the frequency, percent- age, mean, and standard deviation.

Results: According to the findings, the five most common symptoms were orthopnea (83.44%), pitting edema (68.10%), dyspnea on exertion (66.26%), paroxysmal nocturnal dyspnea (PND) (61.35%), and chest pain (39.26%), respectively. The most common atypical symptoms were nausea (22.86%), dry cough (20.86%), fatigue (20.25%), decreased appetite (17.78), and loss of appetite (14.72), respectively. The majority of this subjects (92.21%) preferred sitting as a means of self-management, whilst about half (48.49%) chose to lie down with their heads elevated and less than one-fifth (16.36%) resorted to deep breathing. The emergency department’s primary means of managing the subjects were pharmacological treatment (100%) and oxygen therapy (72.08 %), respectively.

Recommendations: The results of this study suggested that the evaluation of clinical and atypical symptoms of heart failure in older adults are complex. Therefore, nurses should possess the necessary knowledge and competency in screening older adults with congestive heart failure according to their symptoms, to determine care priority and to give them and their caregivers proper advice on the signs, symptoms, and appropriate post-discharge self-management methods.

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