Psychometric testing of the heart failure somatic awareness scale

Description of Symptom Severity in Heart Failure

The purpose of this article is to critically analyze research that describes symptom severity in heart failure. Medline, CINAHL, Psych Info, and Science Direct databases (2000 to July 2006) were searched to locate published studies that described or defined symptom severity or like terms in heart failure. A total of 323 publications were initially reviewed, from which 21 articles (6.51%) were selected based on the inclusion criteria for this article. Multiple terms are used synonymously, and inappropriately at times, to describe symptom severity. Rarely, symptom severity is adequately defined or fully described. Varying instruments and methods are used to measure symptom severity. The literature includes inappropriate measurement methods of symptom severity. Symptom severity should be clearly defined, differentiated from related terms, and measured appropriately. Comparisons across studies are impeded when terms are not clearly defined or inappropriately measured.

Somatic awareness, uncertainty, and delay in care-seeking in acute heart failure

Symptom monitoring is difficult for heart failure (HF) patients. Difficulties physically sensing and determining symptom meaning may lead to uncertainty and delay treatment. Somatic awareness may provide insight into symptom monitoring ability. A model combining physical and cognitive aspects of the symptom experience was developed to examine factors affecting care-seeking among HF patients. Adults hospitalized with acute HF were interviewed and completed questionnaires measuring somatic awareness and uncertainty. HF symptom duration prior to admission measured delay. HF specific somatic awareness and symptom pattern predicted delay. Uncertainty correlated with somatic awareness, but did not predict delay. Few responded to early HF symptoms delaying until acutely ill. Development of interventions to improve symptom monitoring is needed.