Patterns of heart failure symptoms are associated with self-care behaviors over 6 months

Journal article


Auld, Jonathan P., Mudd, James O., Gelow, Jill M., Lyons, Karen S., Hiatt, Shirin O. and Lee, Christopher S.. (2018). Patterns of heart failure symptoms are associated with self-care behaviors over 6 months. European Journal of Cardiovascular Nursing. 17(6), pp. 543-551. https://doi.org/10.1177/1474515118759074
AuthorsAuld, Jonathan P., Mudd, James O., Gelow, Jill M., Lyons, Karen S., Hiatt, Shirin O. and Lee, Christopher S.
Abstract

Background
Both heart failure symptoms and self-care are associated with patient outcomes. Although it is thought that symptoms drive self-care, there is limited evidence to support this assumption over time.

Aims
To determine whether patterns of physical symptoms are significantly associated with heart failure self-care over time.

Method
Latent mixture analysis was used to identify subgroups based on physical symptoms of dyspnea, sleepiness and edema (using the heart failure somatic perception and Epworth sleepiness scales). Growth modeling was used to determine if symptom subgroups were associated with self-care behaviors (using the self-care in heart failure index) over 6 months. Sociodemographic and clinical variables predicting the likelihood of subgroup membership were identified using logistic regression.

Results
The sample (n=146) was on average 57 years old, 70% were men and 59% had class III/IV heart failure. Two symptom subgroups were identified (entropy 0.91): a high symptom group (n=24; 16%) with no significant change in symptoms over time (high sustained), and a low symptom group (n=122; 84%) with no significant change in symptoms over time (low sustained). The high sustained group was associated significantly with better self-care behaviors at baseline and over 6 months. Women (odds ratio (OR) 3.67, P=0.023) and patients with more depressive symptoms (OR 1.16, P=0.015) were more likely to be in the high sustained symptom group. Those treated with a renin–angiotensin–aldosterone system agent were less likely to be in the high symptom group (OR 0.17, P=0.015).

Conclusion
Patients bothered more by symptoms are consistently more engaged in self-care behaviors over time. The results of this study support symptoms as an important driver of self-care behaviors.

Keywordsheart failure; symptoms; self-care; symptom management; depression
Year2018
JournalEuropean Journal of Cardiovascular Nursing
Journal citation17 (6), pp. 543-551
PublisherSAGE Publications Inc.
ISSN1474-5151
Digital Object Identifier (DOI)https://doi.org/10.1177/1474515118759074
Scopus EID2-s2.0-85042122630
Research or scholarlyResearch
Page range543-551
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online01 Aug 2018
Publication process dates
Accepted22 Jan 2018
Deposited04 May 2021
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The influence of group versus individual prenatal care on phase of labor at hospital admission
Tilden, Ellen L., Emeis, Cathy L., Caughey, Aaron B., Weinstein, Sarah R., Futernick, Sarah B. and Lee, Christopher S.. (2016). The influence of group versus individual prenatal care on phase of labor at hospital admission. Journal of Midwifery & Womens Health. 61(4), pp. 427-434. https://doi.org/10.1111/jmwh.12437
The effect of childbirth self-efficacy on perinatal outcomes
Tilden, Ellen L., Caughey, Aaron B., Lee, Christopher S. and Emeis, Cathy. (2016). The effect of childbirth self-efficacy on perinatal outcomes. Journal of Obstetric, Gynecologic, and Neonatal Nursing. 45(4), pp. 465-480. https://doi.org/10.1016/j.jogn.2016.06.003
'Real-life' effectiveness studies of omalizumab in adult patients with severe allergic asthma : Systematic review
Abraham, I., Alhossan, A., Lee, C. S., Kutbi, H. and MacDonald, K.. (2016). 'Real-life' effectiveness studies of omalizumab in adult patients with severe allergic asthma : Systematic review. Allergy. 71(5), pp. 593-610. https://doi.org/10.1111/all.12815
Influence of gender and age on the peripheral immune response in stroke
Ross, Amy Miner, Lee, Christopher S. and Lutsep, Helmi. (2016). Influence of gender and age on the peripheral immune response in stroke. The Journal of Cardiovascular Nursing. 31(4), pp. 331-355. https://doi.org/10.1097/JCN.0000000000000252
Incongruent perceptions of the care values of hospitalized persons with dementia : A pilot study of patient-family caregiver dyads
Miller, Lyndsey M., Whitlatch, Carol J., Lee, Christopher S. and Lyons, Karen S.. (2016). Incongruent perceptions of the care values of hospitalized persons with dementia : A pilot study of patient-family caregiver dyads. Aging and Mental Health. 22(4), pp. 489-496. https://doi.org/10.1080/13607863.2017.1280766
Usefulness of cognitive dysfunction in heart failure to predict cardiovascular risk at 180 days
Gelow, Jill M., Mudd, James O., Chien, Christopher V. and Lee, Christopher S.. (2015). Usefulness of cognitive dysfunction in heart failure to predict cardiovascular risk at 180 days. American Journal of Cardiology. 115(6), pp. 778-782. https://doi.org/10.1016/j.amjcard.2014.12.040
Symptom-hemodynamic mismatch and heart failure event risk
Lee, Christopher S., Hiatt, Shirin O., Denfeld, Quin E., Mudd, James O., Chien, Christopher and Gelow, Jill M.. (2015). Symptom-hemodynamic mismatch and heart failure event risk. Journal of Cardiovascular Nursing. 30(5), pp. 394-402. https://doi.org/10.1097/JCN.0000000000000175
Physical and psychological symptom biomechanics in moderate to advanced heart failure
Denfeld, Quin E., Mudd, James O., Gelow, Jill M., Chien, Christopher, Hiatt, Shirin O. and Lee, Christopher S.. (2015). Physical and psychological symptom biomechanics in moderate to advanced heart failure. Journal of Cardiovascular Nursing. 30(4), pp. 346-350. https://doi.org/10.1097/JCN.0000000000000171
Gender-specific physical symptom biology in heart failure
Lee, Christopher S., Hiatt, Shirin O., Denfeld, Quin E., Chien, Christopher V., Mudd, James O. and Gelow, Jill M.. (2015). Gender-specific physical symptom biology in heart failure. Journal of Cardiovascular Nursing. 30(6), pp. 517-521. https://doi.org/10.1097/JCN.0000000000000191
Determinants of frequent internet use in an urban kidney transplant population in the United States : Characterizing the digital divide
Lockwood, Mark, Saunders, Milda, Josephson, Michelle A., Becker, Yolanda T. and Lee, Christopher. (2015). Determinants of frequent internet use in an urban kidney transplant population in the United States : Characterizing the digital divide. Progress in Transplantation. 25(1), pp. 9-17. https://doi.org/10.7182/pit2015957
The problem with Cronbach's alpha: Comment on Sijtsma and van der Ark (2015)
Barbaranelli, Claudio, Lee, Christopher, Vellone, Ercole and Riegel, Barbara. (2015). The problem with Cronbach's alpha: Comment on Sijtsma and van der Ark (2015). Nursing Research. 64(2), pp. 140 - 145. https://doi.org/10.1097/NNR.0000000000000079
Background and design of the profiling biobehavioral responses to mechanical support in advanced heart failure study
Lee, Christopher S., Mudd, James O., Gelow, Jill M., Nguyen, Thuan, Hiatt, Shirin O., Green, Jennifer K., Denfeld, Quin E., Bidwell, Julie T. and Grady, Kathleen L.. (2014). Background and design of the profiling biobehavioral responses to mechanical support in advanced heart failure study. Journal of Cardiovascular Nursing. 29(5), pp. 405-415. https://doi.org/10.1097/JCN.0b013e318299fa09
Symptom incongruence trajectories in lung cancer dyads
Lyons, Karen S., Lee, Christopher S., Bennett, Jill A., Nail, Lillian M., Fromme, Erik, Hiatt, Shirin O. and Sayer, Aline G.. (2014). Symptom incongruence trajectories in lung cancer dyads. Journal of Pain and Symptom Management. 48(6), pp. 1031-1040. https://doi.org/10.1016/j.jpainsymman.2014.02.004
Psychometric testing on the NLN Student Satisfaction and Self-Confidence in Learning, Simulation Design Scale, and Educational Practices Questionnaire using a sample of pre-licensure novice nurses
Franklin, Ashley E., Burns, Paulette and Lee, Christopher S.. (2014). Psychometric testing on the NLN Student Satisfaction and Self-Confidence in Learning, Simulation Design Scale, and Educational Practices Questionnaire using a sample of pre-licensure novice nurses. Nurse Education Today. 34(10), pp. 1298-1304. https://doi.org/10.1016/j.nedt.2014.06.011
Physical and psychological symptom profiling and event-free survival in adults with moderate to advanced heart failure
Lee, Christopher S., Gelow, Jill M., Denfeld, Quin E., Mudd, James O., Burgess, Donna, Green, Jennifer K., Hiatt, Shirin O. and Jurgens, Corrine Y.. (2014). Physical and psychological symptom profiling and event-free survival in adults with moderate to advanced heart failure. Journal of Cardiovascular Nursing. 29(4), pp. 315-323. https://doi.org/10.1097/JCN.0b013e318285968a
Peripheral immune response and infection in first-time and recurrent ischemic stroke or transient ischemic attack
Ross, Amy Miner, Lee, Christopher S. and Brewer, Margaret. (2014). Peripheral immune response and infection in first-time and recurrent ischemic stroke or transient ischemic attack. Journal of Neuroscience Nursing. 46(4), pp. 199-206. https://doi.org/10.1097/JNN.0000000000000061
Effectiveness of simulation for improvement in self-efficacy among novice nurses : A meta-analysis
Franklin Ashley, E. and Lee Christopher, S.. (2014). Effectiveness of simulation for improvement in self-efficacy among novice nurses : A meta-analysis. Journal of Nursing Education. 53(11), pp. 607-614. https://doi.org/10.3928/01484834-20141023-03
Comparison of expert modeling versus voice-over powerpoint lecture and presimulation readings on novice nurses' competence of providing care to multiple patients
Franklin Ashley, E., Sideras, Stephanie, Gubrud-Howe, Paula and Lee Christopher, S.. (2014). Comparison of expert modeling versus voice-over powerpoint lecture and presimulation readings on novice nurses' competence of providing care to multiple patients. Journal of Nursing Education. 53(11), pp. 615-622. https://doi.org/10.3928/01484834-20141023-01
Comorbidity profiles and inpatient outcomes during hospitalization for heart failure : An analysis of the U.S. Nationwide inpatient sample
Lee, Christopher S., Chien, Christopher V., Bidwell, Julie T., Gelow, Jill M., Denfeld, Quin E., Creber, Ruth Masterson, Buck, Harleah G. and Mudd, James O.. (2014). Comorbidity profiles and inpatient outcomes during hospitalization for heart failure : An analysis of the U.S. Nationwide inpatient sample. BMC Cardiovascular Disorders. 14, p. 73. https://doi.org/10.1186/1471-2261-14-73
Validity and reliability of the European Heart Failure Self-care Behavior Scale among adults from the United States with symptomatic heart failure
Lee, Christopher, Lyons, Karen, Gelow, Jill, Mudd, James, Hiatt, Shirin, Nguyen, Thuan and Jaarsma, Tiny. (2013). Validity and reliability of the European Heart Failure Self-care Behavior Scale among adults from the United States with symptomatic heart failure. European Journal of Cardiovascular Nursing. 12(2), pp. 214 - 218. https://doi.org/10.1177/1474515112469316