21 Any distinctive symptom clusters among patients with advanced heart failure?. (9th April 2018)

• Record Type: Journal Article
• Authors: Yu, Doris
• Is Part Of: Heart Asia. Volume 10(2018)Supplement 1
• Page Start: A7
• Page End: A7
• Publication Date: 2018-04-09
• DOI: 10.1136/heartasia-2018-apahff.21
• Languages: English
• ISSNs: 2398-5968

Abstract

Abstract : Objectives: To investigate for any distinctive 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 Quality of Life Questionnaire (MQOL). 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 for age, gender and co-morbidities. Results: Patients were at an advanced age (mean 82.9 years, standard deviation 6.5). Three distinct symptom clusters were identified: 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 a sense of generalised discomfort). These three symptom clusters accounted for 63.25% of variance of the patients' symptom experience. Low to moderate correlations between these symptom clusters indicated that they were rather independent of one another. After adjusting for age, gender and co-morbidities, the distress (β −0.635, p<0.001), decondition (β −0.148, p=0.01) and discomfort (β −0.258, p<0.001) symptom clusters independently predicted patients' QoL. Conclusion: 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 optimising symptom control for this life-limiting disease.