Thirst in Patients with Heart Failure : Description of thirst dimensions and associated factors with thirst (original) (raw)

2016, Linköping University Medical Dissertations

Introduction: Nurses and other health care professionals meet patients with heart failure (HF) who report they are thirsty. Thirst is described by the patients as a concern, and it is distressing. Currently there are no standardized procedures to identify patients with increased thirst or to help a patient to manage troublesome thirst and research in the area of thirst is scarce. In order to prevent and relieve troublesome thirst more knowledge is needed on how thirst is experienced and what factors cause increased thirst. Aim: The aim of this thesis was to describe the thirst experience of patients with HF and describe the relationship of thirst with physiological, psychological and situational factors. The goal was to contribute to the improvement of the care by identifying needs and possible approaches to prevent and relieve thirst in patients with HF. Methods: The studies in this thesis used a cross-sectional design (Study I) and prospective observational designs (II-IV). Studies include data from patients with HF who were admitted to the emergency department for deterioration in HF (I, IV) or visited an outpatient HF clinic for worsening of HF symptoms (III); others were patients who were following up after HF hospitalization (II), and patients with no HF diagnosis who sought care at the emergency department for other illness (I). Patients completed questionnaires on thirst intensity, thirst distress, HF self-care behaviour, feeling depressive and feeling anxious. Data on sociodemographic, clinical characteristics, pharmacological treatment and prescribed fluid restriction were retrieved from hospital medical records and by asking the patients. Data were also collected from blood, urine and saliva samples to measure biological markers of dehydration, HF severity and stress. Results: Thirst was prevalent in 1 out of 5 patients (II) and 63% of patients with worsening of HF symptoms experienced moderate to severe thirst distress at hospital admission (IV). Patients at an outpatient HF clinic who reported thirst at Although troublesome thirst in patients with HF has been recognized since the early 1900´s, 5 studies of thirst in this patient group have not been conducted until recently. However, the current scientific knowledge about thirst in patients with HF is still weak. 11, 20 There are some studies about thirst in patients with HF, most of them examining effects of restricting fluid intake. 11, 20 Thirst was a secondary outcome in all of the studies or a statement regarding thirst given by the HF patients in interviews. 11 No studies were conducted to describe thirst experience more thoroughly or to find factors that might increase thirst in patients with HF. It is also important to display changes in thirst over time, considering that