Caring about symptoms in person-centred care

In the present article, we emphasize the symptom experience perspective in person-centred care and discuss barriers to implementation of this approach. There are obstacles to overcome: the diversity of understandings of symptoms in clinical settings, the current biomedical discourse and the incompleteness of symptom research. Since the 19th century, the biomedical perspective has been powerful in conceptualizing symptoms in terms of pathology and diagnosis. Many diagnoses conjure up preconceived notions about the persons receiving them. This perspective may influence person-centred care negatively. Yet symptoms often mean something beyond the diagnosis. Recognizing this discrepancy, it is crucial that we consider a perspective that starts from each person’s symptom experience, thus complementing the biomedical perspective. Using the notion caring about symptoms, we advocate a person-centred approach that includes a symptom experience perspective. This requires health-care professionals to be skilled in listening to patient narratives and acquire knowledge about how symptom experiences can be individually expressed and interpreted. Listening to symptom experiences may give insights into the personal meaning of illness as well as information about bodily and social restrictions caused by symptom distress. In this way, caring about symptoms will improve the prerequisites for establishing person-centred care planning.

Influencing factors of fatigue in young and middle-aged patients with coronary heart disease:a cross-sectional study

Objective:To examine the present state of fatigue in young and middle-aged patients with coronary heart disease(CHD)and to identify the elements that may be affecting it.Methods:From December 2020 to June 2021,240 young and middle-aged patients with CHD who were being treated in the cardiology department of a tertiary care hospital in Suzhou were chosen using a convenience sampling method in order to gather data on the patients’sociodemographic status,fatigue,social support,and stress.Results:Of the 240 disseminated questionnaires,220 valid responses were returned,resulting in an effective recovery rate of 91.67%.The frequency of exhaustion was 51.8%,and the fatigue score was(5.27±2.77).The stress score was(11.15±3.36),while the overall social support score was(39.13±4.72).Binary logistic regression analysis indicated that age,exercise,staying up late,stress,social support,high-sensitivity troponin T,high-density lipoprotein,and ejection fraction were independent risk factors for fatigue in young and middle-aged patients with CHD(P<0.05).Conclusions:Fatigue is more prevalent in young and middle-aged patients with CHD.Clinical nurses can create a unique management plan for patients based on their lifestyle and behavioral patterns,stress levels,social support,and clinical signs to reduce fatigue.