Key result
In advanced heart failure, dyspnoea clusters with emotional symptoms rather than typical decompensation symptoms, and symptom burden is strongly associated with cardiac events.
Why the study?
What are the symptom cluster manifestations and their prognostic impacts in patients with advanced heart failure?
Systematic Review (n=10)
What are the symptom cluster manifestations and their prognostic impacts in patients with advanced heart failure?
Advanced heart failure patients exhibit unique symptom clusters, such as dyspnoea clustering with emotional symptoms, highlighting the need for comprehensive symptom palliation.
Supports integrated palliation of dyspnoea with emotional symptoms in advanced HF; extends evidence on symptom clusters and cardiac event links.
PURPOSE OF REVIEW: Assessment of symptom clustering is effective in enhancing care planning for symptom palliation in life-limiting disease. This review was aimed at identifying symptom cluster manifestation among advanced heart failure patients and to investigate the prognostic impact of the identified symptom clusters. RECENT FINDINGS: A systematic search of the literature identified 10 relevant articles. Two approaches were undertaken based on: correlations between symptoms and shared characteristics of patients' symptom profiles, to identify the symptom clusters. By comparing the findings for heart failure patients at an advanced disease stage and those who were not, the symptom clusters of advanced heart failure were found to have unique characteristics. In particular, the typical symptoms associated with cardiac decompensation are not clustered together. Instead, dyspnoea is clustered with emotional symptoms indicating that a distressing dyspnoeic attack may reinforce awareness of the life-limiting nature of the disease and arouse negative emotions. In addition, the debilitating heart failure-specific symptoms share the cause of the life-limiting aspects in compromising patient vitality. The strong positive association between symptom burden and cardiac event prompts the need for effective intervention to palliate not only typical but also atypical and emotional symptoms of advanced heart failure. SUMMARY: This review provides insight on potentially effective interventions for symptom palliation in advanced heart failure.
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Yu et al. (2017) conducted a systematic review in Advanced heart failure (n=10). Symptom clusters was evaluated on Symptom cluster manifestation and prognostic impact. In advanced heart failure, dyspnoea clusters with emotional symptoms rather than typical decompensation symptoms, and symptom burden is strongly associated with cardiac events.
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