Nursing Professor Receives Grant to Study Symptom Management in Heart Failure Patients

January 23, 2008

"By better understanding the thought process behind a patient's decision to seek care we can come up with smarter ways to help patients and their families manage the condition from home rather than a hospital bed."

Recognizing new or worsening symptoms and knowing when to seek care can be difficult for patients with chronic heart failure and their families. Jill Quinn, PhD, RN, ANP, an assistant professor at the University of Rochester School of Nursing, has been awarded more than $300,000 from the American Heart Association (AHA) to research how four factors—symptom perception, depression, quality of life perception and the influence of family caregivers—impact a patient’s ability to recognize symptoms and decide to seek medical care. 

Changes in chronic heart failure symptoms can be subtle and the treatment regimens associated with the condition are complex.  To compound matters, many patients have difficulty deciphering whether a symptom is serious enough to call the doctor.  Quinn’s research is aimed at identifying the factors that influence a patient’s decision to seek medical care and help patients and family caregivers recognize worsening symptoms before they require hospitalization.  Congestive heart failure is a leading cause of hospitalization in the U.S., especially among patients older than 65. The AHA estimates that heart failure-related treatment and hospitalizations accounted for more than $32 billion in health care expenditures last year.

In addition to her symptom study, Quinn is working with researchers from the Center for Future Health at the University of Rochester Medical Center to develop a computerized in-home conversational system to assist chronic heart failure patients with monitoring their symptoms.  The system would use natural spoken language technology to communicate with patients via phone, asking a series of questions about their condition, providing advice based on their responses and then sending that information to the patient’s health care provider for follow-up.  Such a system would help patients and/or their caregivers manage their medical care, provide reminders, answer questions, and engage in dialogue to collect information for monitoring a patient’s current state. The system would not make medical decisions, but would help patients follow the instructions that they have been given by their health care providers, and provide status reports back to medical support teams. Quinn hopes to use the results of her symptom study to inform the application of this technology.

“People with chronic heart failure have good days and bad days,” said Quinn.  “By better understanding the thought process behind a patient’s decision to seek care we can come up with smarter ways to help patients and their families manage the condition from home rather than a hospital bed.”

The study will be conducted with chronic heart failure patients admitted to Strong Memorial and Highland hospitals in Rochester, NY.  The patient and a family caregiver identified by the patient will be interviewed prior to the patient's discharge to gauge each party’s ability to accurately recognize signs and symptoms of worsening heart failure.  The study will also measure how family caregivers affect the patient’s decision to seek care; whether depression in the patient or family caregiver plays a role in the decision to seek care; and, whether the quality of life of the patient as perceived by the patient and as perceived by the family member plays a role in the decision to seek care.  Quinn hopes to complete her study in 2011. 

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