A nurse-led thirst symptom management program for patients with heart failure: from evidence-based design to pilot study

Thirst is a common and distressing symptom among patients with heart failure that impacts treatment adherence, quality of life, and psychological well-being. Despite its clinical significance, evidence-based nursing interventions for thirst management are limited. This study aimed to develop and evaluate the feasibility and acceptability of a nurse-led Thirst Symptom Management (TSM) program for heart failure patients using the Intervention Mapping approach. The TSM program was developed using the six-step Intervention Mapping (IM) framework, including a needs assessment, a change objectives matrix, the development of an initial intervention plan, refinement of the program, and the establishment of an implementation plan. Subsequently, a single-arm, pre- and post-test pilot study was conducted to evaluate the feasibility and acceptability of the TSM program. The TSM program included four multifaceted components, including health behavior and educational guidance, symptom management, psychological support, and family and social engagement. The core interventions consisted of pure water spray applied with a 10 ml spray bottle to the Jinjin and Yuyu (M-HN-20) acupoints behind the tongue and bilateral parotid gland regions, as well as acupoint massage (twice daily for 5–10 min) targeting Shuiquan (KI5). The program also integrated educational components on fluid management, psychological counseling for thirst-related distress, and structured family and social involvement to enhance support. Among 20 enrolled patients (mean age 59.5 ± 13.4 years, 65% were males), 17 (85%) completed the full intervention and follow-up. Three withdrew due to department transfer (n = 2) and lost to follow-up post-discharge (n = 1). All 17 completing participants reported satisfaction (100%), with 88.2% willing to recommend the program. This study provides an evidence-based thirst management program for heart failure patients. The TSM program demonstrated good feasibility and acceptability in a clinical setting. Designed through stakeholder engagement and guided by the Intervention Mapping framework, the program can be embedded into routine nursing care. A future multicenter randomized controlled trial is needed to evaluate the effectiveness of the program. Not applicable.