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. 2024 Jan-Feb;39(1):31-37.
doi: 10.1097/JCN.0000000000001043. Epub 2023 Sep 29.

Physical Symptoms, Depressive Symptoms, and Quality of Life in Patients With Heart Failure: Cluster Analysis

Seongkum Heo, JungHee Kang, Mi-Seung Shin, Young-Hyo Lim, Sun Hwa Kim, Sangsuk Kim, Minjeong An, JinShil Kim

Physical Symptoms, Depressive Symptoms, and Quality of Life in Patients With Heart Failure: Cluster Analysis

Seongkum Heo et al. J Cardiovasc Nurs. 2024 Jan-Feb.

Abstract

Background: Physical and psychological symptoms are prevalent in patients with heart failure (HF) and are associated with poor quality of life (QOL) and high hospitalization rates. Thus, it is critical to identify symptom clusters to better manage patients with high-risk symptom cluster(s) and to reduce adverse effects.

Objective: The aims of this study were to identify clusters of physical HF symptoms (ie, dyspnea during daytime, dyspnea when lying down, fatigue, chest pain, edema, sleeping difficulty, and dizziness) and depressive symptoms and to examine their association with QOL in patients with HF.

Methods: In this secondary analysis of a cross-sectional study, data on physical HF symptoms (Symptom Status Questionnaire), depressive symptoms (Patient Health Questionnaire-9), and general QOL (European Quality of Scale-Visual Analog Scale) were collected. We identified clusters based on the physical HF symptoms and depressive symptoms using 2-step and k -means cluster analysis methods.

Results: Chest pain was removed from the model because of the low importance value. Two clusters were revealed (cluster 1, severe symptom cluster, vs cluster 2, less severe symptom cluster) based on the 7 symptoms. In cluster 1, all of the 7 symptoms were more severe, and QOL was poorer than those in cluster 2 (all P s < .001). All the mean and median scores of the 7 symptoms in cluster 1 were higher than those in cluster 2.

Conclusions: Patients with HF were clearly divided into 2 clusters based on physical HF symptoms and depressive symptoms, which were associated with QOL. Clinicians should assess these symptoms to improve patient outcomes.

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Conflict of interest statement

The authors have no funding or conflicts of interest to disclose.

References

    1. Wu JR, Lee KS, Dekker RD, et al. Prehospital delay, precipitants of admission, and length of stay in patients with exacerbation of heart failure. Am J Crit Care . 2016;26(1):62–69.
    1. Jering K, Claggett B, Redfield MM, et al. Burden of heart failure signs and symptoms, prognosis, and response to therapy: the PARAGON-HF trial. JACC Heart Fail . 2021;9(5):386–397.
    1. Heo S, Shin MS, Hwang SY, et al. Sex differences in heart failure symptoms and factors associated with heart failure symptoms. J Cardiovasc Nurs . 2019;34(4):306–312.
    1. Heo S, Moser DK, Lennie TA, et al. Prediction of heart failure symptoms and health-related quality of life at 12 months from baseline modifiable factors in patients with heart failure. J Cardiovasc Nurs . 2020;35(2):116–125.
    1. Heo S, Moser DK, Lennie TA, et al. Changes in heart failure symptoms are associated with changes in health-related quality of life over 12 months in patients with heart failure. J Cardiovasc Nurs . 2018;33(5):460–466.