Nana Waldréus dissertation

2016-04-18 13.48.58

The D-day on the 18th of April 2016 was finally here! D as for dissertation. Four and a half years is quite a long time working hard with your studies and manuscripts. Doing your courses and attending seminars, as well as participating on congresses. Although the work was hard many times, I will always remember these years as so rewarding. Not only that I learned so much, but I also grew as a human being. I thought I had prepared my “mind” for the upcoming defense of my dissertation. When preparing myself the last months, I realized that it is impossible to be prepared for everything. One just has to be in the present moment and trust yourself. So, only two days before the D-day, I went to the EuroHeartCare congress in Athen with CESAR´s, having a doctoral students’ abstract presentation about thirst in patients with heart failure! Being in the present moment.

Professor Anna Forsberg, from Lunds University, was the faculty opponent and did a great work asking me all kinds of relevant and interesting questions about my thesis. The grading committee did also a great work highlighting significant aspects of my research. I was so in the present moment, that when there were no more questions, I realized that three hours had passed! It felt like one hour…. The D-day ended with a nice dinner with my dear friends whom I had the good fortune to get to know during these years!

2016-04-18 12.59.41

My thesis has the title “Thirst in Patients with Heart Failure: Description of thirst dimensions and associated factors with thirst”. The aim of the thesis was to describe the thirst experience of patients with heart failure and describe the relationship of thirst with physiologic, psychologic and situational factors. The goal was to contribute to the improvement of the care by identifying needs and possible approaches to prevent and relieve thirst in patients with heart failure.

The main results of the four studies in the thesis were:

  • Thirst was prevalent in 1 out of 5 patients with stable heart failure
  • 63% of patients with worsening of heart failure symptoms experienced moderate to severe thirst distress at hospital admission
  • Thirst intensity was significantly higher in patients hospitalized with decompensated heart failure compared to patients with no HF (median 75 vs. 25 mm, visual analogue scale [VAS] 0-100 mm; P < 0.001)
  • Patients at an outpatient heart failure clinic who reported thirst at the first visit were more often thirsty at the follow-up visits compared to patients who did not report thirst at the first visit
  • Patients with heart failure who were admitted to the hospital with high thirst distress continued to have high thirst distress over time
  • Patients with heart failure who had a fluid restriction had high thirst distress over time
  • Patients with heart failure who were feeling depressed had high thirst intensity over time
  • Thirst was associated with fluid restriction, a higher serum urea, and depressive symptoms


In conclusion, patients with heart failure experience thirst intensity and thirst distress. Nurses should ask patients with heart failure if they are thirsty and measure the thirst intensity and thirst distress, and ask if thirst is bothering them. Each patient should be critically evaluated if a fluid restriction really is needed, if the patient might be dehydrated or needs to be treated for depression.

The thesis can be accessed at


Nana Waldréus, PhD, RN