Experiences and management of breathing and shortness of breath in patients with chronic heart failure – a qualitative study

Shortness of breath is a cardinal symptom of heart failure. However, little is known about patients’ subjective experiences and how patients with chronic heart failure manage shortness of breath. This study aimed to describe the experiences and management of breathing and shortness of breath in patients with stable symptomatic chronic heart failure. This qualitative study used a descriptive design. Data were collected through assessment tool assisted interviews, using the Experiences of Breathing and Shortness of Breath (Exp-BeSoB). Outpatients with stable heart failure in functional classes II − III who were on optimized medical treatment were included. Qualitative content analyses were conducted. Forty-five participants (median age, 74 years), 37 (82%) reported normal breathing and wellness at rest. Varied personal and multidimensional experiences of shortness of breath were found. Shortness of breath was described as a lack of air and energy and associated with physical exertion and environmental factors. Different, frightening, and challenging shortness of breath experiences also emerged. Participants developed management strategies, that they found effective. Three themes representing patient experience were identified: Shortness of breath as a life-threatening experience, Difficulty breathing slows the body down, grabbing one’s focus and Breathing is not a problem and of no concern. Applied personal management strategies differed within and between the themes. Shortness of breath in stable heart failure can present in various ways and can be effectively managed. Results highlight the importance of clinicians exploring the patients’ breathing symptoms, their thoughts about the symptom, emotional and existential dimensions, impact in daily life, and management strategies, which might help to identify patients’ needs for breathing care. Further research is needed.