4.3 Article

The Association Between Regular Symptom Monitoring and Self-care Management in Patients With Heart Failure

Journal

JOURNAL OF CARDIOVASCULAR NURSING
Volume 30, Issue 2, Pages 145-151

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JCN.0000000000000128

Keywords

heart failure; self-care; symptom assessment

Funding

  1. National Institute of Nursing Research [NIH R01 NR008567]
  2. NIH National Institute of Nursing Research [1P20NR010679]
  3. National Center for Advancing Translational Sciences of the National Institutes of Health [UL1TR000454]
  4. Atlanta Veterans Administration Hospital

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Background: Symptom monitoring is considered the first step toward self-care management (actions to manage altered symptom status) to avert worsening heart failure (HF). However, empirical evidence demonstrating that symptom monitoring leads to adequate self-care management is lacking. We examined the relationship of adherence to regular symptom monitoring with adequate self-care management in HF patients. Methods and Results: A total of 311 HF patients (60 years, 35% women) were divided into 3 groups by adherence to 2 symptom monitoring behaviors (monitoring daily weights and lower extremity edema). Patients who were adherent to both symptom monitoring behaviors formed the adherent group (15.1%). Those adherent to either of the symptom monitoring behaviors formed the partially adherent group (28.9%). Those adherent to neither of the symptom monitoring behaviors formed the nonadherent group (56.0%). The adjusted odds of performing adequate self-care management were increased by 225% (95% confidence interval, 1.13-4.48) and 344% (95% confidence interval, 1.55-7.62) for the partially adherent and adherent symptom monitoring groups, respectively, compared with the nonadherent group. Conclusion: Adequacy of self-care management was predicted by adherence to symptom monitoring behaviors. This finding suggests that regular symptommonitoring facilitates performance of adequate self-care management, which may contribute to a decrease in preventable hospitalizations in HF.

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