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heart failure, self-care, symptom assessment



  1. Lee, Kyoung Suk PhD, RN, MPH
  2. Lennie, Terry A. PhD, RN, FAAN
  3. Dunbar, Sandra B. DSN, RN
  4. Pressler, Susan J. PhD, RN
  5. Heo, Seongkum PhD, RN
  6. Song, Eun Kyeung PhD, RN
  7. Biddle, Martha J. PhD, APRN
  8. Moser, Debra K. DNSc, RN, FAAN


Background: Symptom monitoring is considered the first step toward self-care management (actions to manage altered symptom status) to avert worsening heart failure (HF). However, empirical evidence demonstrating that symptom monitoring leads to adequate self-care management is lacking. We examined the relationship of adherence to regular symptom monitoring with adequate self-care management in HF patients.


Methods and Results: A total of 311 HF patients (60 years, 35% women) were divided into 3 groups by adherence to 2 symptom monitoring behaviors (monitoring daily weights and lower extremity edema). Patients who were adherent to both symptom monitoring behaviors formed the adherent group (15.1%). Those adherent to either of the symptom monitoring behaviors formed the partially adherent group (28.9%). Those adherent to neither of the symptom monitoring behaviors formed the nonadherent group (56.0%). The adjusted odds of performing adequate self-care management were increased by 225% (95% confidence interval, 1.13-4.48) and 344% (95% confidence interval, 1.55-7.62) for the partially adherent and adherent symptom monitoring groups, respectively, compared with the nonadherent group.


Conclusion: Adequacy of self-care management was predicted by adherence to symptom monitoring behaviors. This finding suggests that regular symptom monitoring facilitates performance of adequate self-care management, which may contribute to a decrease in preventable hospitalizations in HF.