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Improving heart failure symptom recognition: a diary analysis.
J Cardiovasc Nurs. 2010 Jan-Feb; 25(1):7-12.JC

Abstract

BACKGROUND

Heart failure (HF) is a costly and highly disabling syndrome affecting nearly 5 million individuals yearly. Lifestyle changes are crucial to the successful management of HF, and daily weight monitoring is an essential component of self-care. Daily weights provide an objective indicator of fluid volume status in patients with HF. However, the practice of performing daily weights is underappreciated and infrequently implemented by patients. This may contribute to an inability to recognize worsening HF and, ultimately, delay in seeking medical care.

OBJECTIVE

The aim of this study was to evaluate weight monitoring diaries for adherence to daily weight monitoring, reasons for nonadherence, prevalence of weight gain of 3 lb or more in 1 day, and medical advice-seeking behavior after weight gain in a sample of patients with documented HF.

METHODS

A cohort study design was used to analyze data from 20 HF patients who participated in a tailored, one-on-one educational intervention. The analysis is part of a parent pilot study designed to improve symptom recognition and response to symptoms of fluid overload. Diary data were collected for 3 months after the intervention. The diaries provided information regarding symptoms that participants experienced, daily weights, and a record of unplanned hospital visits or contacts with their physician.

RESULTS

Of 20 participants in the study, 16 returned diaries for analysis. Two participants withdrew participation before the conclusion of the study and 2 participants who claimed to have completed their diary never returned the diary despite repeated reminders and telephone calls. Sixteen participant diaries were therefore available for analysis. The mean adherence score for these 16 participants was 79.4%. Seventy-five percent had weight gains of 3 lb or more in 1 day and only 1 person contacted his/her physician for weight gain. Vacation time was the most common reason for weighing nonadherence.

CONCLUSION

This study revealed high adherence to daily weights in patients receiving an education session focused on fluid weight management. However, behavior related to daily weights did not lead to more appropriate use of physician or provider consultation. Diaries offer promise for symptom management and an opportunity for patients to engage in self-care; however, clinicians need to encourage patients to use the diary data to seek prompt medical care.

Authors+Show Affiliations

Department of Cardiac Surgery, Northwestern Memorial Hospital, Chicago, IL, USA. mmwhite01@hotmail.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20134279

Citation

White, Megan M., et al. "Improving Heart Failure Symptom Recognition: a Diary Analysis." The Journal of Cardiovascular Nursing, vol. 25, no. 1, 2010, pp. 7-12.
White MM, Howie-Esquivel J, Caldwell MA. Improving heart failure symptom recognition: a diary analysis. J Cardiovasc Nurs. 2010;25(1):7-12.
White, M. M., Howie-Esquivel, J., & Caldwell, M. A. (2010). Improving heart failure symptom recognition: a diary analysis. The Journal of Cardiovascular Nursing, 25(1), 7-12. https://doi.org/10.1097/JCN.0b013e3181b7af9e
White MM, Howie-Esquivel J, Caldwell MA. Improving Heart Failure Symptom Recognition: a Diary Analysis. J Cardiovasc Nurs. 2010 Jan-Feb;25(1):7-12. PubMed PMID: 20134279.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improving heart failure symptom recognition: a diary analysis. AU - White,Megan M, AU - Howie-Esquivel,Jill, AU - Caldwell,Mary A, PY - 2010/2/6/entrez PY - 2010/2/6/pubmed PY - 2010/4/24/medline SP - 7 EP - 12 JF - The Journal of cardiovascular nursing JO - J Cardiovasc Nurs VL - 25 IS - 1 N2 - BACKGROUND: Heart failure (HF) is a costly and highly disabling syndrome affecting nearly 5 million individuals yearly. Lifestyle changes are crucial to the successful management of HF, and daily weight monitoring is an essential component of self-care. Daily weights provide an objective indicator of fluid volume status in patients with HF. However, the practice of performing daily weights is underappreciated and infrequently implemented by patients. This may contribute to an inability to recognize worsening HF and, ultimately, delay in seeking medical care. OBJECTIVE: The aim of this study was to evaluate weight monitoring diaries for adherence to daily weight monitoring, reasons for nonadherence, prevalence of weight gain of 3 lb or more in 1 day, and medical advice-seeking behavior after weight gain in a sample of patients with documented HF. METHODS: A cohort study design was used to analyze data from 20 HF patients who participated in a tailored, one-on-one educational intervention. The analysis is part of a parent pilot study designed to improve symptom recognition and response to symptoms of fluid overload. Diary data were collected for 3 months after the intervention. The diaries provided information regarding symptoms that participants experienced, daily weights, and a record of unplanned hospital visits or contacts with their physician. RESULTS: Of 20 participants in the study, 16 returned diaries for analysis. Two participants withdrew participation before the conclusion of the study and 2 participants who claimed to have completed their diary never returned the diary despite repeated reminders and telephone calls. Sixteen participant diaries were therefore available for analysis. The mean adherence score for these 16 participants was 79.4%. Seventy-five percent had weight gains of 3 lb or more in 1 day and only 1 person contacted his/her physician for weight gain. Vacation time was the most common reason for weighing nonadherence. CONCLUSION: This study revealed high adherence to daily weights in patients receiving an education session focused on fluid weight management. However, behavior related to daily weights did not lead to more appropriate use of physician or provider consultation. Diaries offer promise for symptom management and an opportunity for patients to engage in self-care; however, clinicians need to encourage patients to use the diary data to seek prompt medical care. SN - 1550-5049 UR - https://www.unboundmedicine.com/medline/citation/20134279/Improving_heart_failure_symptom_recognition:_a_diary_analysis_ L2 - https://doi.org/10.1097/JCN.0b013e3181b7af9e DB - PRIME DP - Unbound Medicine ER -