Heart failure symptom clusters and quality of life

Abstract

Background: Heart failure (HF) is a progressive symptomatic illness with reports suggesting that patients experience multiple symptoms. Symptom clusters constitute symptoms that co-occur, are related, and influence outcomes.

Objectives: The specific aims of this study were to (1) examine prevalent symptoms experienced by persons with HF, (2) identify symptoms forming clusters, and (3) evaluate the impact of HF symptom clusters on quality of life (QOL).

Methods: 117 participants (62% male; 50% black; age = 56) were recruited. Prevalent symptoms were evaluated; principle components analysis (PCA) was used to extract symptom clusters; regression analysis was used to evaluate factors influencing QOL, defined as life satisfaction.

Results: Three symptom clusters-sickness behavior, discomforts of illness, and GI distress-were extracted. Sickness behavior significantly influenced QOL (β = -0.603 p = 0.0001), explaining 40% of the variance (F = 75.12; R² = 0.404; p = 0.0001).

Conclusions: The Sickness Behavior cluster had a negative impact on QOL and suggests that incorporating an evaluation of these symptoms may facilitate identification and treatment of symptoms having an additive and detrimental influence on QOL. Studies to examine the stability of the clusters are warranted.

Keywords: Heart failure; Quality of life; Symptom clusters; Symptoms.