Nurses Explore How Heart Failure Patients, Families Manage Illness

Recognition of heart failure symptoms by patients and their family caregivers together has a measurable impact on their decision to contact their health care providers, according to new findings presented by nurses at the annual meeting of the American Heart Association.

With a grant from the AHA, Jill Quinn, Ph.D., assistant professor at the University of Rochester School of Nursing, is exploring the factors that influence heart patients’ decisions to seek medical care, including their quality of life, depression, and symptoms such as swelling, weight gain, fatigue, shortness of breath and confusion.

Quinn’s study involved interviewing 233 patient subjects hospitalized for worsening heart failure and 146 caregivers/significant others. They were interviewed before leaving the hospital to determine if, why, and when they contacted their primary medical providers before coming to the hospital. They also answered specific symptom-recognition questions. The team found that recognition of symptoms – and the belief that there could be life-threatening consequences if they did not seek care – had the biggest impact on the decision to contact their providers.

“Patients and caregivers who recognized worsening symptoms together, and believed there could be consequences to those symptoms, were more likely to contact their providers than those who did not,” said Quinn. “To me this is another piece of the puzzle that shows we need to keep digging deeper about how these close patient-caregiver relationships shape patient decisions and ultimately may affect outcomes.”

Quinn’s research includes collaboration with computer scientists to develop a computerized conversational system that would give patients 24-hour assistance in monitoring their symptoms from home. Drawing upon input from experienced nurse practitioners, the technology would help heart failure patients receive prompt answers to questions and manage their symptoms at home, and complement the role of the nurses managing their care.

Together with researchers Irena Pesis-Katz, Ph.D., Quinn hopes to conduct a large-scale study of the role formal caregivers play in the symptom recognition and management of heart failure patients who reside in nursing homes. The research would include data from 1,500 nursing homes across the country.

“People living with heart failure need our support,” said Quinn. “Controlling their condition involves huge lifestyle changes that can be especially hard for older people who may live alone, have memory loss or loss of mobility. The goal of all of my work is to give heart failure patients the assistance they need to monitor their health, so they can make better choices, avoid or delay hospitalizations, and improve the quality of their lives.”