“I Regret Not Coming in Sooner⋯”: A Qualitative Descriptive Study of the Reasons for Emergency Department Visits and Care Preferences of Older Adults With Heart Failure

Symptom perception in heart failure: a scoping review on definition, factors and instruments

“…Manuscript types included 46 observational studies, 2, 7, 14, 21–63 27 qualitative studies, 4, 64–89 12 literature reviews, 16, 17,…”

“…115 Some of the 106 references related to more than one of the research questions. Twelve included references related to HF symptom perception definition, 1, 8, 17, 27, 34, 43, 54, 75, 80, 100, 102, 106 68 to description, 2–4, 7, 10, 16, 17, 21–42, 49, 64–74, 76–79, 81–87, 89…”

“…Most studies report that body observation is not systematic in patients with HF. 4, 10, 17, 24, 25, 28, 29, 39, 41, 66, 67, 70, 83, 90, 96, 98 Only a minority of patients monitor symptoms regularly 24, 64, 80 and considered symptom monitoring to be important 86 for controlling HF. 64, 74, 78 In a large study, 16 of 22 studies (from 15 countries) reported irregular weight monitoring in more than half of patients.…”

“…Body analysis following body observation is often poor because patients have difficulty recognising signs and symptoms related to chronic HF 4, 21, 31, 33, 36, 66, 67, 74, 81, 83, 93, 98, 101, 107 as well as signs of decompensation. 17, 23, 34–36, 42, 65 Patients have difficulty quantifying subtle changes in dyspnoea 108 and noting changes in symptom status.…”

“…25, 31, 38, 80, 82 Other responses are more avoidant in nature such as ignoring symptoms 68, 74, 81 or adopting a ‘wait and see’ strategy 102 in hopes that symptoms will resolve spontaneously. 3, 4, 72, 81 These strategies can delay help-seeking, 38, 97 or patients may only seek medical support if symptoms do not resolve, 82 or symptoms escalate interfering with daily life activities, 27 or become unmanageable, 76, 80 leading to emergency situations 67, 79, 115 and hospitalisation. 107 Only some patients seek medical attention to understand or interpret the significance of symptoms 70 and learned about it when seeking care.…”