ORCID Identifier(s)

0000-0003-3809-4391

Graduation Semester and Year

2020

Language

English

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Nursing

Department

Nursing

First Advisor

Donelle M Barnes

Abstract

Heart failure (HF) is a significant disease condition affecting 6.5 million Americans. Breathlessness is the hallmark symptom of HF impacting affected individual’s functional capacity and quality of life. It is a subjective symptom best described by individuals experiencing it, yet there are very few qualitative studies to understand this phenomenon in HF. The purpose of this study was to explore how adults with HF describe their experiences of breathlessness, determine characteristics, types and patterns, explore the impact of breathlessness on their daily life, and explore how affected individuals manage their breathlessness. Fourteen participants with diagnosis of HF and self-report of breathlessness were interviewed to explore their descriptions of their breathlessness experiences, types and patterns, the impact it had on their daily life and management strategies employed. Thematic analysis was used to analyze the interviews. Five themes were identified to describe the nature of their breathlessness: no air, accompanying symptoms, “just happens”, general shortness of breath vs. cannot breathe, and first reaction. As part of the interview, the participants were asked to draw a graph depicting the severity and duration of their typical episode of breathlessness. Two patterns of episodic breathlessness were identified: group I – quick onset and slow recover and group II – similar time for onset and recovery. Two types of breathlessness episodes were described: triggered episode with predictable response and the triggered or non-triggered wave-like episode. Four themes were identified to describe the impact of breathlessness on their daily life: feeling guilt or self-responsibility, “I used to”, helplessness, and forecasting. Adults with HF employ strategies to mitigate the impact of breathlessness on their daily life with four themes identified: stop and breathe, acceptance or carry on, adapting, planning, and new perspective The study findings reveal the need to educate adults with HF recognize and understand their breathlessness, the need for a multidisciplinary care approach to address the multidimensional impact of this symptom and assist them in developing effective and evidenced-based management strategies.

Keywords

Breathlessness, chronic heart failure

Disciplines

Medicine and Health Sciences | Nursing

Comments

Degree granted by The University of Texas at Arlington

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