Symptom experience, symptom management strategies and health related quality of life among patients with heart failure admitted to the hospitals in Myanmar

Abstract

This cross-sectional, descriptive correlational study aimed to describe the symptom experience (prevalence, frequency, severity, and distress) after admission (time 1) and one month after discharge (time 2), examine changes in symptom experience between those two times, describe symptom management strategies and health-related quality of life (HRQOL), and determine the predictability of symptom experience, symptom management strategies, and selected variables (age, employment status, comorbid condition) on HRQOL among patients with heart failure in Myanmar. The Theory of Symptom Management was used as a conceptual framework, and 140 patients with heart failure were recruited from three general hospitals by purposive sampling. Data were collected by self-administered structured questionnaires including the Personal Information Questionnaire, the Minnesota Living with Heart Failure Questionnaire, the Memorial Symptom Assessment Scale-Heart Failure, and the Symptom Management Strategies-Heart Failure. The results indicated that almost equal percentages of female and male (51% vs. 49%) with an average age of 59.35 (SD=13.79) years involved in the study and 30% of them were employed. On average, the participants had 3.21 (SD=1.12) comorbid conditions and experienced 14.72 (SD = 4.94) symptoms at time 1 and 8.93 (SD=3.25) at time 2. Shortness of breath was rated as one of the top-ranked symptoms in almost all dimensions at both times. However, changes in rankings of symptom experience were found statistically significant between two times at p<0.001. The participants used an average of 18.53 (SD=5.02) symptom management strategies and reported mean HRQOL as a moderate level (39.89 ± 12.78). Hierarchical multiple regression analysis revealed that the variability of HRQOL can be predicted 51.8% by the symptom experience (prevalence, severity, and distress) and symptom management strategies together with age and comorbid condition [R 2 =0.518, F(6,133)=23.845, p<.001]. The findings will guide the implications for nursing practice in symptom management of heart failure. Further studies are suggested to identify relationships among symptoms and develop an effective symptom management program for improving health-related quality of life among patients with heart failure.