Patient descriptions of breathlessness in heart failure.
OBJECTIVE
To explore patient experience of breathlessness in heart failure.


METHODS
Semi-structured interviews were undertaken with 27 patients with chronic heart failure and were analysed using a constant comparative approach.


RESULTS
The patients had a mean age of 69 (range 38-94 years). All had chronic heart failure with a mean left ventricular ejection fraction of 33.1%. The patient narratives suggested three dominant experiences of breathlessness, "everyday", "worsening" and "uncontrollable". These descriptions predominantly focused on physical functioning, relating to patients' ability to manage breathlessness on a day to day basis. Patients were able to accommodate everyday breathlessness, using a number of coping strategies. In most cases this experience of breathlessness came to be accepted as "normal". Worsening breathlessness was a symptom that patients were unable to manage and that prompted a hospital admission, whereas uncontrollable breathlessness was experienced as a symptom that even health care professionals struggled to control.


CONCLUSIONS
Patients' descriptions of breathlessness are distinct from medical terminology and more clearly relate to physical adaptations to breathlessness. Further research is required to identify whether heart failure patients' descriptions of breathlessness are different to those of cancer patients, and to establish whether the categories generated from this data set are applicable to other heart failure patients in other settings.
Edmonds
Polly M
PM
Department of Palliative Care and Policy, King's College London, King's Denmark Hill Campus, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK.
Rogers
Angie
A
Addington-Hall
Julia M
JM
McCoy
Anne
A
Coats
Andrew J S
AJ
Gibbs
J Simon R
JS
D000203:Activities of Daily Living / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004417:Dyspnea / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D033262:Narration; D012107:Research Design; D018434:Sickness Impact Profile; D013318:Stroke Volume