title: Reasons for seeking acute care in chronic heart failure.
abstract: BACKGROUND
  Patients with chronic heart failure (CHF) have frequent episodes of exacerbation leading to recurrent hospitalization.
  
  
  OBJECTIVE
  To explore factors related to patients seeking care for worsening CHF.
  
  
  METHODS
  Eighty-eight patients diagnosed with a deteriorating CHF condition were interviewed. Data were analysed using content analysis.
  
  
  RESULTS
  Overall, 51 (58%) patients sought emergency care because of their symptoms while 37 (42%) were either sent by relatives or referred from outpatient clinics. Delay in seeking care was explained by 62 (71%) patients as a "wait and see" strategy, 9 (10%) were reluctant to use the health care system and 10 (11%) felt that it was futile to seek care. Fifty percent of the patients were uncertain about their current deteriorating status. Only 4 patients reported their symptoms to be related to heart failure.
  
  
  CONCLUSIONS
  Although symptoms were the dominant reason for seeking emergency care, only a few patients related their symptoms to worsening CHF, which might be an important factor for not seeking emergency care earlier. Patient education programs should make efforts to improve understanding of symptom recognition.
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy at Göteborg University, Sweden. Harshidaben.patel@vgregion.se <Harshidaben.patel@vgregion.se>
authors.forename: Harshida
authors.initials: H
authors.lastname: Patel
authors.forename: Masoud
authors.initials: M
authors.lastname: Shafazand
authors.forename: Maria
authors.initials: M
authors.lastname: Schaufelberger
authors.forename: Inger
authors.initials: I
authors.lastname: Ekman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D018450:Disease Progression; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010343:Patient Admission; D012803:Sick Role; D013548:Sweden