Perceived Control Predicts Symptom Status in Patients With Heart Failure.
Chin-Yen Lin, Jennifer L Miller, Terry A Lennie and 4 others
PMID 32398498WHAT IT FOUND
Heart failure patients who felt less control over their illness reported worse symptom burden, especially more frequent, severe, and distressing symptoms.
This was independent of depression, age, and disease severity.
Key findings
01Lower perceived control independently predicted worse heart failure symptom status after age, gender, disease class, comorbidity, and depression were considered.
02Lower perceived control was associated with more frequent, more severe, and more distressing symptoms, but not with how many symptoms were present.
03Higher perceived control was related to better heart failure self-care confidence and self-care, and better self-care was related to better symptom status.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis used only baseline data and was cross-sectional, so it cannot show that perceived control caused better or worse symptoms. It was a secondary analysis, so variables not collected in the parent study, such as heart failure cause or ejection fraction, could not be included. The sample was mostly white, mostly had at least a high school education, and came from one southern state, so results may not apply broadly. The psychological symptom subscale was left out of the main model because it overlapped with depression, so the analysis focused on physical and heart failure-specific symptoms. The study did not test an intervention to increase perceived control, so it cannot show that improving control would improve symptoms.
Declared interests
The authors reported no conflicts of interest. The paper is listed as supported by NIH extramural research funding.
The easy way to misread this
Do not conclude that teaching patients to feel more control will improve their symptoms. This study measured patients at a single time point and did not test an intervention, so it shows an association, not a cause.