Symptom Experiences in Patients with Heart Failure

Abstract

Introduction The prevalence of heart failure (HF) is increasing in Thailand. While current treatment approaches play a crucial role in prolonging life, patients with HF may experience worsening symptoms over time. This can lead to re-admission, along with the ongoing challenge of managing persistent and distressing symptoms throughout their lives. 

Objective This study aimed to describe symptom experiences among patients with HF, including symptom occurrence, frequency, severity, distress, and overall symptom. 

Design This study employed a descriptive design, adopting the Theory of Unpleasant Symptoms as its conceptual framework. 

Methods Through purposive sampling, the participants included 264 patients with HF aged 18 years or older, and classified as having heart functional class II or III based on the New York Heart Association classification. Data were collected using a demographic form and the Thai version of the Memorial Symptom Assessment Scale-Heart Failure (MSAS-HF). The reliability testing of the overall MSAS-HF in this study yielded a Cronbach’s alpha coefficient of .83. Descriptive statistics were used to analyze all dimensions of symptoms. 

Results Over half of the participants were male (56.80%), ranging in age from 27 to 92 years, with an average age of 66.71 years (SD = 11.76). Out of the 32 total symptoms, the participants reported experiencing approximately 30 symptoms. The symptoms that were not reported included issues related to sexual interest or activity and vomiting. The most prevalent symptoms were difficulty breathing when lying flat (71.21%), shortness of breath (70.83%), cough (64.77%), lack of energy (61.36%), and difficulty sleeping (53.79%). Each patient experienced between 3 to 20 symptoms, with an average of about 9 symptoms per patient (SD = 2.46). Difficulty breathing when lying flat ranked highest across severity (M = 3.44, SD = 0.18) and distress dimensions (M = 3.36, SD = 0.18). 

Recommendation This study highlights the diverse symptom dimensions experienced by patients with HF. Remarkably, only certain patient groups experienced a multitude of symptoms, and specific symptoms were identified as problematic. This information is valuable for identifying high-risk groups that may benefit from targeted symptom management. Additionally, it emphasizes the need for ongoing, thorough symptom assessments for these patients.