Abstract:

Objective To conduct a systematic review on the symptom clusters of patients with heart failure. Methods Databases including Embase，PubMed，CINAHL，Cochrane Library，Web of Science，CNKI，CBM，VIP，and Wanfang were searched for studies on symptom clusters in patients with heart failure from the establishment of databases to November 7，2024. Two researchers independently performed literature screening and data extraction. After evaluating the methodological quality of the literature—using the cross-sectional study quality assessment criteria recommended by the Agency for Healthcare Research and Quality（AHRQ） for cross-sectional studies and the Newcastle-Ottawa Scale（NOS） for cohort studies，the types and characteristics of symptom clusters，assessment tools，analytical methods，and influencing factors were analyzed. Results A total of 28 literatures were included，and 48 symptom clusters were extracted. The five most common symptom clusters in patients with heart failure were congestion symptom cluster，emotional symptom cluster，ischemic symptom cluster，fatigue symptom cluster and dyspnea symptom cluster in sequence. There were 16 evaluation tools，among which Memorial Symptom Assessment Scale for Heart Failure（MSAS-HF） was used the most. There were four analytical methods，among which cluster analysis was the most widely used. The influencing factors classified into three categories：demographic factors；disease-related factors；psychological and social support，and other factors. Conclusion Patients with heart failure have diverse symptom clusters，which are affected by multiple factors. In the future，it is necessary to further develop standards for symptom attribution and symptom cluster naming in patients with heart failure，develop localized assessment tools for symptom clusters in these patients and optimize the identification methods of symptom clusters，and expand the research perspectives on influencing factors.

Key words: Heart Failure, Symptom Clusters, Assessment Tools, Influencing Factors, Systematic Review