Regular symptom monitoring enables early detection and treatment of heart failure exacerbations, thus reducing preventable hospital admissions. Gallager determined the level of self management and frequency of symptom monitoring and factors associated in patients with moderate severity heart failure (HF) living in the community. A correlational study of a convenience sample of patients recently admitted or enrolled in treatment for heart failure were interviewed twice, one month apart, on self management and the frequency of monitoring five key heart failure symptoms. Participants (n=63) had an age mean of 78.38years (SD 8.54years), and approximately half were male (57%) and married (56%). Daily monitoring occurred in 69.8% for peripheral edema, 65% for weight, 41.3% for fatigue, 38.9% for dyspnea during normal activity, and 28.6% for dyspnea at night or at rest. At baseline, better self-management was predicted by more comorbid conditions and stronger sense of coherence, and one month later, by the baseline self-management score. The only predictor of symptom monitoring at one month was the frequency of monitoring at baseline.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: Gallager concluded that neither self-management nor symptom monitoring is ideal in people with HF. As these behaviors did not change by themselves over time, interventions are needed early in the illness course.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: The study nicely demonstrated that unless you undergo self-management training, you are unlikely to perform the self-management skills are taught. As self-monitoring is important in heart failure, you should be taught ways to monitor you condition, to record your data, to make efficient decisions, and to take the proper action as to control HF.

R Gallager. Self-management, symptom monitoring and associated factors in people with heart failure living in the community. European Journal of Cardiovascular Nursing, January 19, 2010.