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European Journal of Heart Failure 2007 9(6-7):702-708; doi:10.1016/j.ejheart.2006.11.002
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© 2007 European Society of Cardiology

Reasons for seeking acute care in chronic heart failure

Harshida Patela,b,*, Masoud Shafazandc, Maria Schaufelbergerc and Inger Ekmana

a Institute of Health and Care Sciences, Sahlgrenska Academy at Göteborg University, Sweden
b The Vårdal Institute, Göteborg University, Göteborg, Sweden
c Institute of Medicine, Sahlgrenska Universitetssjukhuset, Östra, Göteborg, Sweden

* Corresponding author. The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Box 457, SE 405 30 Göteborg, Sweden. Tel.: +46 705 308895. E-mail address: Harshidaben.patel{at}vgregion.se


  Abstract

Background: Patients with chronic heart failure (CHF) have frequent episodes of exacerbation leading to recurrent hospitalization.

Aims: To explore factors related to patients seeking care for worsening CHF.

Methods: Eighty-eight patients diagnosed with a deteriorating CHF condition were interviewed. Data were analysed using content analysis.

Results: Overall, 51 (58%) patients sought emergency care because of their symptoms while 37 (42%) were either sent by relatives or referred from outpatient clinics. Delay in seeking care was explained by 62 (71%) patients as a "wait and see" strategy, 9 (10%) were reluctant to use the health care system and 10 (11%) felt that it was futile to seek care. Fifty percent of the patients were uncertain about their current deteriorating status. Only 4 patients reported their symptoms to be related to heart failure.

Conclusions: Although symptoms were the dominant reason for seeking emergency care, only a few patients related their symptoms to worsening CHF, which might be an important factor for not seeking emergency care earlier. Patient education programs should make efforts to improve understanding of symptom recognition.

Key Words: Congesti heart failure • Signs and symptoms • Disease progression • Decision making • Delay

Received June 16, 2006; Revised September 13, 2006; Accepted November 9, 2006


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