Corrine Y Jurgens1, Christopher S Lee, Barbara Riegel. 1. Corrine Y. Jurgens, PhD, RN, ANP, FAHA, FAAN Associate Professor, School of Nursing, Stony Brook University, New York. Christopher S. Lee, PhD, RN, FAHA, FAAN Associate Professor, School of Nursing, Oregon Health & Science University, Portland. Barbara Riegel, PhD, RN, FAHA, FPCNA, FAAN Edith Clemmer Steinbright Professor of Gerontology, School of Nursing, University of Pennsylvania, Philadelphia.
Abstract
BACKGROUND: Symptoms are known to predict survival among patients with heart failure (HF), but discrepancies exist between patients' and health providers' perceptions of HF symptom burden. OBJECTIVE: The purpose of this study is to quantify the internal consistency, validity, and prognostic value of patient perception of a broad range of HF symptoms using an HF-specific physical symptom measure, the 18-item HF Somatic Perception Scale v. 3. METHODS: Factor analysis of the HF Somatic Perception Scale was conducted in a convenience sample of 378 patients with chronic HF. Convergent validity was examined using the Physical Limitation subscale of the Kansas City Cardiomyopathy Questionnaire. Divergent validity was examined using the Self-care of HF Index self-care management score. One-year survival based on HF Somatic Perception Scale scores was quantified using Cox regression controlling for Seattle HF Model scores to account for clinical status, therapeutics, and lab values. RESULTS: The sample was 63% male, 85% white, 67% functionally compromised (New York Heart Association class III-IV) with a mean (SD) age of 63 (12.8) years. Internal consistency of the HF Somatic Perception Scale was α = .90. Convergent (r = -0.54, P < .0001) and divergent (r = 0.18, P > .05) validities were supported. Controlling for Seattle HF scores, HF Somatic Perception Scale was a significant predictor of 1-year survival, with those most symptomatic having worse survival (hazard ratio, 1.012; 95% confidence interval, 1.001-1.024; P = .038). CONCLUSIONS: Perception of HF symptom burden as measured by the HF Somatic Perception Scale is a significant predictor of survival, contributing additional prognostic value over and above objective Seattle HF Risk Model scores. This analysis suggests that assessment of a broad range of HF symptoms, or those related to dyspnea or early and subtle symptoms, may be useful in evaluating therapeutic outcomes and predicting event-free survival.
BACKGROUND: Symptoms are known to predict survival among patients with heart failure (HF), but discrepancies exist between patients' and health providers' perceptions of HF symptom burden. OBJECTIVE: The purpose of this study is to quantify the internal consistency, validity, and prognostic value of patient perception of a broad range of HF symptoms using an HF-specific physical symptom measure, the 18-item HF Somatic Perception Scale v. 3. METHODS: Factor analysis of the HF Somatic Perception Scale was conducted in a convenience sample of 378 patients with chronic HF. Convergent validity was examined using the Physical Limitation subscale of the Kansas City Cardiomyopathy Questionnaire. Divergent validity was examined using the Self-care of HF Index self-care management score. One-year survival based on HF Somatic Perception Scale scores was quantified using Cox regression controlling for Seattle HF Model scores to account for clinical status, therapeutics, and lab values. RESULTS: The sample was 63% male, 85% white, 67% functionally compromised (New York Heart Association class III-IV) with a mean (SD) age of 63 (12.8) years. Internal consistency of the HF Somatic Perception Scale was α = .90. Convergent (r = -0.54, P < .0001) and divergent (r = 0.18, P > .05) validities were supported. Controlling for Seattle HF scores, HF Somatic Perception Scale was a significant predictor of 1-year survival, with those most symptomatic having worse survival (hazard ratio, 1.012; 95% confidence interval, 1.001-1.024; P = .038). CONCLUSIONS: Perception of HF symptom burden as measured by the HF Somatic Perception Scale is a significant predictor of survival, contributing additional prognostic value over and above objective Seattle HF Risk Model scores. This analysis suggests that assessment of a broad range of HF symptoms, or those related to dyspnea or early and subtle symptoms, may be useful in evaluating therapeutic outcomes and predicting event-free survival.
Authors: John E A Blair; Sadiya Khan; Marvin A Konstam; Karl Swedberg; Faiez Zannad; John C Burnett; Liliana Grinfeld; Aldo P Maggioni; James E Udelson; Christopher A Zimmer; John Ouyang; Chien-Feng Chen; Mihai Gheorghiade Journal: Eur Heart J Date: 2009-05-02 Impact factor: 29.983
Authors: Christopher S Lee; Jill M Gelow; Quin E Denfeld; James O Mudd; Donna Burgess; Jennifer K Green; Shirin O Hiatt; Corrine Y Jurgens Journal: J Cardiovasc Nurs Date: 2014-07 Impact factor: 2.083
Authors: Inger Ekman; John G F Cleland; Karl Swedberg; Andrew Charlesworth; Marco Metra; Philip A Poole-Wilson Journal: J Card Fail Date: 2005-05 Impact factor: 5.712
Authors: Christopher S Lee; Jill M Gelow; Christopher V Chien; Shirin O Hiatt; Julie T Bidwell; Quin E Denfeld; Kathleen L Grady; James O Mudd Journal: J Cardiovasc Nurs Date: 2018 Mar/Apr Impact factor: 2.083
Authors: Christopher S Lee; Quin E Denfeld; Bradley E Aouizerat; Corrine Y Jurgens; Christopher V Chien; Emily Aarons; Jill M Gelow; Shirin O Hiatt; James O Mudd Journal: Heart Lung Date: 2018-10-09 Impact factor: 2.210
Authors: Quin E Denfeld; James O Mudd; Wohaib Hasan; Jill M Gelow; Shirin O Hiatt; Kerri Winters-Stone; Christopher S Lee Journal: Heart Lung Date: 2018-05-24 Impact factor: 2.210
Authors: Jonathan P Auld; James O Mudd; Jill M Gelow; Karen S Lyons; Shirin O Hiatt; Christopher S Lee Journal: Heart Lung Date: 2019-01-02 Impact factor: 2.210
Authors: Kenneth M Faulkner; Corrine Y Jurgens; Quin E Denfeld; Karen S Lyons; Jessica Harman Thompson; Christopher S Lee Journal: Heart Lung Date: 2020-05-18 Impact factor: 2.210
Authors: Jonathan P Auld; James O Mudd; Jill M Gelow; Shirin O Hiatt; Christopher S Lee Journal: J Cardiovasc Nurs Date: 2018 May/Jun Impact factor: 2.083
Authors: Quin E Denfeld; Kerri Winters-Stone; James O Mudd; Shirin O Hiatt; Christopher S Lee Journal: J Cardiovasc Nurs Date: 2018 Jan/Feb Impact factor: 2.083
Authors: Quin E Denfeld; Julie T Bidwell; Jill M Gelow; James O Mudd; Christopher V Chien; Shirin O Hiatt; Christopher S Lee Journal: Heart Lung Date: 2019-11-18 Impact factor: 2.210