Aims Patients with heart failure (HF) experience various signs and symptoms and have difficulties in perceiving them. Integrating insights from patients who have engaged in the process of symptom perception is crucial for enhancing our understanding of the theoretical concept of symptom perception. This study aimed to describe how patients with HF perceive symptoms through the processes of monitoring, awareness, and evaluation and what influences the process. Methods and results Using a qualitative descriptive design, we conducted in-person semi-structured interviews with a purposeful sample of 40 adults experiencing an unplanned hospitalization for a HF symptom exacerbation. We elicited how patients monitor, become aware of, and evaluate symptoms prior to hospitalization. Data were analysed using directed qualitative content analysis. One overarching theme and three major themes emerged. Patients demonstrated Body listening, which involved active and individualized symptom monitoring tactics to observe bodily changes outside one's usual range. Trajectory of bodily change involved the patterns or characteristics of bodily changes that became apparent to patients. Three subthemes—sudden and alarming change, gradual change, and fluctuating change emerged. Patients evaluated symptoms through an Exclusionary process, sequentially attributing symptoms to a cause through a cognitive process of excluding possible causes until the most plausible cause remained. Facilitators and barriers to symptom monitoring, awareness, and evaluation were identified. Conclusion This study elaborates the comprehensive symptom perception process used by adults with HF. Tailored nursing interventions should be developed based on the factors identified in each phase of the process to improve symptom perception in HF.

中文翻译：

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心力衰竭患者的监测、意识和评估的症状感知过程：一项定性描述性研究

目的 心力衰竭 (HF) 患者会经历各种体征和症状，并且难以察觉。整合参与症状感知过程的患者的见解对于增强我们对症状感知理论概念的理解至关重要。本研究旨在描述心力衰竭患者如何通过监测、意识和评估过程感知症状以及影响该过程的因素。方法和结果 我们采用定性描述性设计，对 40 名因心力衰竭症状恶化而计划外住院的成年人进行了有目的的抽样调查。我们引出了患者在住院前如何监测、了解和评估症状。使用定向定性内容分析来分析数据。出现了一个总体主题和三个主要主题。患者表现出身体倾听，这涉及主动和个性化的症状监测策略，以观察超出正常范围的身体变化。身体变化的轨迹涉及患者明显的身体变化的模式或特征。出现了三个副主题——突然而令人震惊的变化、渐进的变化和波动的变化。患者通过排除过程评估症状，通过排除可能原因的认知过程依次将症状归因于某个原因，直到保留最可能的原因。确定了症状监测、认识和评估的促进因素和障碍。结论 本研究详细阐述了心力衰竭成人所使用的综合症状感知过程。应根据每个阶段确定的因素制定量身定制的护理干预措施，以改善心力衰竭的症状感知。