Symptom clusters and quality of life among patients with advanced heart failure
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AbstractObjectives To identify symptom clusters among patients with advanced heart failure (HF) and the independent relationships with their quality of life (QoL). Methods This is the secondary data analysis of a cross-sectional study which interviewed 119 patients with advanced HF in the geriatric unit of a regional hospital in Hong Kong. The symptom profile and QoL were assessed by using the Edmonton Symptom Assessment Scale (ESAS) and the McGill QoL Questionnaire. Exploratory factor analysis was used to identify the symptom clusters. Hierarchical regression analysis was used to examine the independent relationships with their QoL, after adjusting the effects of age, gender, and comorbidities. Results The patients were at an advanced age (82.9 +/- 6.5 years). Three distinct symptom clusters were identified: they were the distress cluster (including shortness of breath, anxiety, and depression), the decondition cluster (fatigue, drowsiness, nausea, and reduced appetite), and the discomfort cluster (pain, and sense of generalized discomfort). These three symptom clusters accounted for 63.25% of variance of the patients' symptom experience. The small to moderate correlations between these symptom clusters indicated that they were rather independent of one another. After adjusting the age, gender and comorbidities, the distress (beta = -0.635, P < 0.001), the decondition (beta = -0.148, P = 0.01), and the discomfort (beta = -0.258, P < 0.001) symptom clusters independently predicted their QoL. Conclusions This study identified the distinctive symptom clusters among patients with advanced HF. The results shed light on the need to develop palliative care interventions for optimizing the symptom control for this life-limiting disease.
All Author(s) ListYu DSF, Chan HYL, Leung DYP, Hui E, Sit JWH
Journal nameJournal of Geriatric Cardiology
Volume Number13
Issue Number5
Pages408 - 414
LanguagesEnglish-United Kingdom
KeywordsAdvanced heart failure; Palliative care model; Quality of life; Symptom clusters
Web of Science Subject CategoriesCardiac & Cardiovascular Systems; Cardiovascular System & Cardiology; Geriatrics & Gerontology

Last updated on 2020-01-12 at 01:25