Impact of Symptom Prevalence and Symptom Burden on Quality of Life in Patients with Heart Failure

Zambroski, Cheryl Hoyt; Moser, Debra K.; Bhat, Geetha; Ziegler, Craig

doi:10.1016/j.ejcnurse.2005.03.010

Cited by 375 publications

(434 citation statements)

References 48 publications

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“…Identifi cation and a holistic assessment of burdensome symptoms should alert nurses and other healthcare professionals that the goal of care may not be the complete alleviation but rather to decrease the burden of those symptoms (Zambroski et al, 2005). The interventions should be focused on the symptom experience as well as infl uencing factors and the consequences the symptom experience may have on the individual's daily life.…”

Section: Symptommentioning

confidence: 99%

“…The most prevalent symptoms reported by the patients were, in addition to dyspnea and fatigue, dry mouth, diffi cult sleeping, bodily pain and loss of balance. Commonly reported psychological symptoms were diffi culty concentrating, anxiety and depressed mood (Bennett et al, 2000;Zambroski et al, 2005;Patel et al, 2006). Patients with end-stage heart failure had symptoms similar to those of cancer and frequently reported nausea, loss of appetite and constipation (Nordgren & Sörensen, 2003).…”

Section: Symptoms In Patients With Chronic Heart Failurementioning

confidence: 99%

“…Patients described a number of relatively rare symptoms (e.g., numbness/tingling of the hands or feet, itching, problems with sexual interest and activity and change in food taste) as particularly distressing or burdensome. On the other hand, dry mouth, chest pain and feeling drowsy were highly prevalent but not ranked as particularly distressing (Zambroski et al, 2005). Patel and co-workers (2006) found that symptoms, especially shortness of breath, were the dominant reason for seeking care, even though only a few patients related their symptoms to worsening of CHF.…”

Section: Symptoms In Patients With Chronic Heart Failurementioning

confidence: 99%

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Fatigue is a Prevalent and Severe Symptom Associated with Uncertainty and Sense of Coherence in Patients with Chronic Heart Failure

Falk

Swedberg

Gaston‐Johansson

et al. 2007

European Journal of Cardiovascular Nursing

100

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Although fatigue is a prevalent and distressing symptom in patients with chronic heart failure (CHF), it is an underestimated problem in the care of patients, and consequently, insuffi ciently investigated. The primary aim of this thesis was, therefore, to advance the knowledge from the patients' perspective by describing characteristics of the fatigue experience and its consequences in daily life in patients with CHF. A secondary aim was to investigate the relationships between fatigue and selected physiological and psychological factors associated with fatigue. Both quantitative and qualitative methods have been used and three samples of patients have been interviewed on different occasions. In two of the quantitative studies 93 patients, and in another study 112 patients, consecutively included, were interviewed at the hospital. Fifteen patients were included in the qualitative study. These 15 participants were enrolled when they visited an outpatient clinic and most of them were interviewed in their homes. These interviews were supplemented with the content of an Internet discussion with persons living with CHF.The results of the studies indicated that fatigue embraces the individual's body, emotions and cognitive abilities, forcing the person to physical restrictions that, in turn, perpetuate emotional discomfort. However, the physical sensation of fatigue followed by functional limitations seemed to be the most prevalent and distressing experience in patients with CHF. The patients described fatigue as lacking strength, which was associated in connection with physical efforts and lacking energy, viewed as an annoying sensation after both mental and physical strain. Another dimension of fatigue was described as being sleepy, often with a rapid and unforeseen onset. Consequences of fatigue, such as refraining from daily chores, denying oneself opportunities for rejoice and social isolation, further exaggerated the experience of fatigue. Restorative activities that engaged, absorbed or distracted the patients counteracted these negative consequences. Depressed mood was related to those fatigue dimensions that compromised functional ability and motivation to start any activities, whereas anxiety was associated with cognitive impairment. Feelings of uncertainty were related to physical tiredness, possibly infl icted by limitations in performing activities. Symptom distress that was caused by a number of reported symptoms other than fatigue had a diminutive infl uence on fatigue and separate symptoms that were associated with fatigue were, with the exception of breathlessness, not the fi rst and most pressing symptom reported by the patients. Anemic patients reported more fatigue compared with non-anemic patients and functional status, according to the New York Heart Association (NYHA) functional classifi cation criteria, was associated with those fatigue dimensions that encompassed physical tiredness and reduced functioning.The fi ndings provide new insights on the characteristics of fatigue and its con...

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Section: Symptommentioning

confidence: 99%

Section: Symptoms In Patients With Chronic Heart Failurementioning

confidence: 99%

Section: Symptoms In Patients With Chronic Heart Failurementioning

confidence: 99%

See 1 more Smart Citation

Fatigue is a Prevalent and Severe Symptom Associated with Uncertainty and Sense of Coherence in Patients with Chronic Heart Failure

Falk

Swedberg

Gaston‐Johansson

et al. 2007

European Journal of Cardiovascular Nursing

100

View full text Add to dashboard Cite

show abstract

“…Fatigue is reported in both quantitative [1,2] and qualitative [3,4] studies to be one of the most common and distressing symptoms among people with chronic heart failure (CHF). In a group of elderly with CHF over 80% reported fatigue, shortness of breath, having difficulties to walk or climb stairs and having to rest during the day [2].…”

Section: Introductionmentioning

confidence: 99%

The Experience of Fatigue among Elderly Women with Chronic Heart Failure

Hägglund

Boman

Lundman

2008

European Journal of Cardiovascular Nursing

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Background: Fatigue is a common and distressing symptom in chronic heart failure (CHF). Most of the current methods for evaluating patients' symptoms fail to consider the meaning or importance that these symptoms have for the patient. Aim: To illuminate the lived experience of fatigue among elderly women with CHF. Method: Narrative interviews were conducted with 10 women with CHF, aged 73-89 years. Interviews were analysed with qualitative content analysis. Results: The findings are presented in two themes and five subthemes. The first theme, 'living with the loss of physical energy', was based on three subthemes describing the experience of fatigue: 'experiencing a substantial presence of feebleness and unfamiliar bodily sensations', 'experiencing unpredictable variations in physical ability', and 'needing help from others in daily life'. The second theme, 'striving for independence while being aware of deteriorating health', describes how the women managed their life situation; it was based on two subthemes: 'acknowledging one's remaining abilities', and 'being forced to adjust and struggle for independence'. Conclusions: Fatigue was experienced as loss of physical energy, leading to discrepancies between intention and capacity. The will to reduce dependency on others involved a daily struggle against fatigue.

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“…Over the last 30 years, a better understanding of the pathophysiology of heart failure has enabled a range of pharmacological, device, and cardiac surgical therapies to improve the outlook for our patients, particularly those with heart failure with reduced ejection fraction. Many patients now live longer with heart failure but are still subject to a significant burden of physical and psychological symptoms and a relatively poor quality of life 2, 3, 4, 5…”

mentioning

confidence: 99%

Palliative care in heart failure: facts and numbers

Riley

Beattie

2016

ESC Heart Failure

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Millions of people worldwide have heart failure. Despite enormous advances in care that have improved outcome, heart failure remains associated with a poor prognosis. Worldwide, there is poor short‐term and long‐term survival. The 1 year survival following a heart failure admission is in the range of 20–40% with between‐country variation. For those living with heart failure, the symptom burden is high. Studies report that 55 to 95% of patients experience shortness of breath and 63 to 93% experience tiredness. These symptoms are associated with a high level of distress (43–89%). Fewer patients experience symptoms such as constipation (25–30%) or dry mouth (35–74%). However, when they do, such symptoms are associated with high levels of distress (constipation: 15–39%; dry mouth: 14–33%). Psychological symptoms also predominate with possibly as many as 50% experiencing depression. Palliative care services in heart failure are not widely available. Even in countries with well‐developed services, only around 4% of patients are referred for specialist palliative care. Many patients and their families would benefit from receiving specialist palliative care support.

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Impact of Symptom Prevalence and Symptom Burden on Quality of Life in Patients with Heart Failure

Abstract: Patients with heart failure experience a high level of symptoms and symptom burden. Nurses should target interventions to decrease frequency, severity, distress and overall symptom burden and improve HRQOL.

Cited by 375 publications

References 48 publications

Fatigue is a Prevalent and Severe Symptom Associated with Uncertainty and Sense of Coherence in Patients with Chronic Heart Failure

Fatigue is a Prevalent and Severe Symptom Associated with Uncertainty and Sense of Coherence in Patients with Chronic Heart Failure

The Experience of Fatigue among Elderly Women with Chronic Heart Failure

Palliative care in heart failure: facts and numbers

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