Symptom recognition and health care seeking among immigrants and native Swedish patients with heart failure

Abstract

BackgroundIt is not known what patient perceptions or beliefs lead to beneficial decisions or response patterns in symptom interpretation among heart failure (HF) patients, especially immigrants. The aim of this study was to explore and compare symptom recognition and health care seeking patterns among immigrants and native Swedes with HF.MethodsThe study used a qualitative design. Semi-structured interviews were conducted with 42 patients with HF, of whom 21 were consecutively selected immigrants and 21 were randomly selected Swedish patients. The interviews were analysed using content analysis.ResultsA majority of the immigrant patients sought health care for symptoms and signs, such as breathing difficulties, fatigue and swelling. Twice as many immigrants as Swedes were unaware of "what the illness experience entailed" and which symptoms indicated worsening of HF.ConclusionThe symptoms that patients sought care for, were similar among immigrants and Swedes. However, when interpreting symptoms more immigrants were unaware of the connection between the symptoms/signs and their HF condition. More tailored educational interventions might improve recognition of worsening symptoms in immigrant patients with chronic heart failure.

Structural equation model testing the situation‐specific theory of heart failure self‐care

“…The only study demonstrating that symptom monitoring and treatment adherence were associated with symptom recognition and evaluation was a study demonstrating that immigrants to Sweden were unaware of the connection of their symptoms with HF (Hedemalm et al . ), which led to delays in treatment implementation and help seeking behaviour (Patel et al . ).…”

Country of birth and risk of hospitalization due to heart failure: a Swedish population-based cohort study

“…Sweden has a health care system which is financed by the community, and no insurance is needed. According to recently published Swedish studies, the Swedish health care system has achieved equality in the care and treatment of patients with HF (42,43). In these studies symptom recognition and health care seeking were rather similar among immigrants and natives Swedes who were hospitalised due to HF (42,43).…”

“…According to recently published Swedish studies, the Swedish health care system has achieved equality in the care and treatment of patients with HF (42,43). In these studies symptom recognition and health care seeking were rather similar among immigrants and natives Swedes who were hospitalised due to HF (42,43). In the city of Malmö there is only one hospital and patients from all residential areas can reach the hospital within 15 minutes, so the availability of the hospital could be regarded to be similar for all patients.…”

Care-seeking decisions for worsening symptoms in Heart Failure: a qualitative metasynthesis

“…Patients often did not seek care until symptoms became intolerable [55,51,67,59,56,72,74]. Frightening attacks of acute breathlessness were the most common reason patients sought professional care [51,49,56,74].…”

“…External appraisals may take the form of friends, family and HCPs noticing worsening conditions when symptoms went unnoticed by patients [67,59].…”