ArticleFrontiers in cardiovascular medicine2026
Recognition of worsening heart failure symptoms, help-seeking attitudes, and time-to-presentation in chronic heart failure: a single-center KAP study in China.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Timely recognition and prompt help-seeking for worsening heart failure (HF) mitigate deterioration, yet patient-side delays remain common in China. This study evaluated how knowledge, attitudes, and practices (KAP) relate to time-to-presentation (TTP). Methods: In a single-center cross-sectional study (March 2022-April 2025), adults with chronic HF completed a standardized KAP instrument; clinical data were abstracted. Among those with a worsening episode in the prior six months, TTP was categorized (≤6, 7-12, 13-24, 25-48, >48 h). Prespecified analyses comprised logistic regression for early presentation (≤6 h) adjusted for education, NYHA class, knowledge (per-point), written action plan, and insurance; ordinal models for knowledge categories; and structural-equation modeling of the Knowledge→Attitudes→Self-care→TTP pathway. Results: Among the 2,110 patients, recognition was highest for breathlessness/edema/fatigue (80%-85%), ∼60% for weight gain/orthopnea, and lowest for paroxysmal nocturnal dyspnea, dizziness/fainting, confusion/sleepiness, and oliguria (45%, 42%, 39%, 33%). Attitudes were favorable (early help-seeking 90%; trust 87%; self-efficacy 78%), but barriers were common (clinic hours/crowding 42%; costs 37%; transport 29%). Self-care diverged (medication adherence 83%; daily weight 21%). Latent classes (Proactive, Ambivalent, Barrier-Focused) and knowledge domains (Classical, Advanced, Acute-change) were observed. Among those with recent worsening ( Conclusion: Content-specific education, written action plans, and access facilitation-particularly for lower-education and uninsured groups-are pragmatic levers to shorten patient-dependent delays in worsening HF.
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