Latent transition analysis of home-based fluid management during the vulnerable phase in patients with chronic heart failure: impact on symptom burden

Objective To explore the transition in latent categories of home fluid management in patients with chronic heart failure (CHF) over time and their correlation with symptom burden. Methods Convenience sampling selected 268 CHF patients. The Home Fluid Management Scale and Memorial Symptom Assessment Scale were utilized to measure the research subjects one month (T1) and three months (T2) after discharge. Latent profile analysis, latent transition analysis, and Logistic regression were applied for statistical testing. Results There were 252 valid questionnaires (94.03% effective rate). At T1 and T2, three latent profiles of home fluid management were identified: high, medium, and low-level groups. Latent transition analysis revealed varying stability and transition rates among these groups. For instance, 13.89%, 26.59%, and 9.91% remained persistently in the high, medium, and low-level groups, respectively, while others transitioned between levels (e.g., 7.94% high to medium, 3.17% high to low). Multivariate logistic regression showed that compared to the sustained high-level group, all other groups—including persistent medium (OR=4.477), persistent low (OR=11.917), and all transition groups (e.g., high-medium OR=2.702, high-low OR=6.482)—had significantly increased risks of high symptom burden scores (all P < 0.05). Conclusions 50.39% of the patients with chronic heart failure remained in their original latent state, 21.03% of the patients experienced a deterioration in their management status, and 28.58% of the patients showed positive improvement. Compared with the persistent high - level group, the severity of symptom burden in patients with chronic heart failure, including those in the persistent medium - level group, the persistent low - level group, and various transition groups to the moderate and low - level groups, was significantly higher.