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Trajectory of thirst intensity and distress from admission to 4-weeks follow up at home in patients with heart failure

Authors Waldréus N, Chung ML, van der Wal MHL, Jaarsma T

Received 9 March 2018

Accepted for publication 2 June 2018

Published 24 October 2018 Volume 2018:12 Pages 2223—2231

DOI https://doi.org/10.2147/PPA.S167724

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 3

Editor who approved publication: Dr Johnny Chen


Nana Waldréus,1 Misook L Chung,2 Martje HL van der Wal,3,4 Tiny Jaarsma5,6

1Department of Neurobiology, Division of Nursing, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; 2College of Nursing, University of Kentucky, Lexington, KY, USA; 3Department of Social and Welfare Studies, Division of Nursing Science, Faculty of Medical and Health Sciences, Linköping University, Linköping, Sweden; 4Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; 5Department of Social and Welfare Studies, Division of Nursing Science, Faculty of Medical and Health Sciences, Linköping University, Linköping, Sweden; 6Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia

Background:
Patients with heart failure (HF) can suffer from increased thirst intensity and distress. Trajectories of thirst intensity and distress from hospital to home are unclear. The aim of this study was to describe thirst intensity and distress trajectories in patients from the time of hospital admission to 4 weeks after discharge, and describe trajectories of thirst intensity and distress by patients’ characteristics (gender, age, body mass index [BMI], plasma urea, anxiety, and depression).
Patients and methods: In this observational study, data were collected from patients with HF (n=30) at hospital admission, discharge, and at 2 and 4 weeks after discharge. Thirst intensity (visual analog scale, 100 mm) and distress (Thirst Distress Scale-HF, score 9–45) were used. Trajectories were examined using growth modeling.
Results: Trajectory of the thirst intensity was significantly different, for patients with low and high thirst intensity levels (median cut-off 39 mm), from admission to 4 weeks follow up (thirst increased and decreased, respectively). Patients with high level of thirst distress (median score >22) at admission, having fluid restriction and women continued to have higher thirst distress over time. Patients feeling depressed had higher thirst intensity over time. There were no differences in the trajectories of thirst intensity and distress by age, BMI, plasma urea, and anxiety.
Conclusion: Intensity and distress of thirst, having fluid restriction, and feeling depressed at the admission were critical in predicting the trajectory of thirst intensity and distress after discharge to home in patients with HF. Effective intervention relieving thirst should be provided before their discharge to home.

Keywords:
heart failure, thirst intensity, thirst distress, trajectories, fluid restriction

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