Abstract
Introduction
Patients with advanced heart failure (HF) experience many burdensome symptoms that
increase patient suffering.
Methods
Comparative secondary analysis of 347 patients with advanced HF. Symptom burden was
measured with the Memorial Symptom Assessment Scale-HF. Depression was measured using
the Patient Health Questionnaire-9.
Results
Mean number of symptoms was 13.6. The three most frequent symptoms were non-cardiac
pain, shortness of breath, and lack of energy. Patients with depression reported higher
symptom burden. Symptom burden differed when compared by gender. Women reported higher
symptom burden for other pain, dry mouth, swelling of the arms and legs, sweats, feeling
nervous, nausea, and vomiting. Men reported higher symptom burden with sexual problems.
Conclusions
Given the high rates of symptoms and distress, interventions are needed to alleviate
the symptom burden of patients with advanced HF. Reported symptom burden in patients
with advanced heart failure was higher when depressive symptoms were present. Women
reported varied number and severity of symptoms than men.
Keywords
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References
- Heart disease and stroke statistics-2018 update: a report from the American Heart Association.Circulation. 2018; 137: e67-e492
- Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association.Circ Heart Fail. 2013; 6: 606-619
- Symptom burden in heart failure: assessment, impact on outcomes, and management.Heart Fail Rev. 2017; 22: 25-39
Colucci WS, Dunlay SM. Clinical Manifestations and Diagnosis of Advanced Heart Failure. In: Yeon S, ed. UpToDate. Waltham, MA.: UpToDate, 2017. www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-advanced-heart-failure. Accessed 6/21/2018
- Depression is associated with reduced physical activity in persons with heart failure.Health Psychol. 2012; 31: 754-762
- The influence of age, gender, and race on the prevalence of depression in heart failure patients.J Am Coll Cardiol. 2004; 43: 1542-1549
- Association between obesity and heart failure symptoms in male and female patients.Clin Obes. 2017; 7: 77-85
- Depression in heart failure: a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes.J Am Coll Cardiol. 2006; 48: 1527-1537
- Depression in heart failure: can PHQ-9 help?.Int J Cardiol. 2016; 221: 246-250
- Executive summary: heart disease and stroke statistics–2014 update: a report from the American Heart Association.Circulation. 2014; 129: 399-410
- Women with heart failure are disproportionately studied as compared to prevalence: a review of published studies from 2013.J Cardiovasc Nurs. 2016; 31 (PMID): 84-88
- Systematic review of symptom clusters in cardiovascular disease.Eur J Cardiovasc Nurs. 2016; 16: 6-17
- Heart failure symptom clusters and functional status - a cross-sectional study.J Adv Nurs. 2015; 71: 1274-1287
- Cluster analysis of symptom occurrence to identify subgroups of heart failure patients: a pilot study.J Cardiovasc Nurs. 2010; 25: 273-283
- Symptom clusters of heart failure.Res Nurs Health. 2009; 32: 551-560
- Symptom clusters in men and women with heart failure and their impact on cardiac event-free survival.J Cardiovasc Nurs. 2010; 25: 263-272
- Identification of symptom clusters among patients with heart failure: an international observational study.Int J Nurs Stud. 2014; 51: 1366-1372
- Symptom clusters predict event-free survival in patients with heart failure.J Cardiovasc Nurs. 2010; 25: 284-291
- Investigating pain in heart failure patients: the pain assessment, incidence, and nature in heart failure (PAIN-HF) study.J Card Fail. 2012; 18: 776-783
- An analysis and evaluation of the theory of unpleasant symptoms.ANS Adv Nurs Sci. 2017; 40: e16-e39
- The middle-range theory of unpleasant symptoms: an update.ANS Adv Nurs Sci. 1997; 19: 14-27
- Depression and pain comorbidity: a literature review.Arch Intern Med. 2003; 163: 2433-2445
- The memorial symptom assessment scale: an instrument for the evaluation of symptom prevalence, characteristics and distress.Eur J Cancer. 1994; 30a (1326-1336)
- Patients with heart failure who die in hospice.Am Heart J. 2005; 149: 558-564
- Utility of patient-reported outcome instruments in heart failure.JACC Heart Fail. 2016; 4: 165-175
- Use of the memorial symptom assessment scale-heart failure in heart failure patients.Circulation. 2004; 110: 739
- The PHQ-9: validity of a brief depression severity measure.J Gen Intern Med. 2001; 16: 606-613
- Cognitive deficits and health-related quality of life in chronic heart failure.J Cardiovasc Nurs. 2010; 25: 189-198
- A short social support measure for patients recovering from myocardial infarction: the ENRICHD social support inventory.J Cardiopulm Rehabil. 2003; 23: 398-403
- A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.J Chronic Dis. 1987; 40: 373-383
- Symptoms experienced by heart failure patients in hospice care.J Hosp Palliat Nurs. 2013; 15: 13-21
- Exploring symptom clusters in people with heart failure.Clin Nurs Res. 2017; (1054773817729606)
- Symptom clusters and quality of life among patients with advanced heart failure.J Geriat Cardiol. 2016; 13: 408-414
- 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.Eur Heart J. 2016;
- ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.J Am Coll Cardiol. 2013; 62: e147-e239
- Executive summary: HFSA 2010 comprehensive heart failure practice guideline.J Card Fail. 2010; 16: 475-539
- An evaluation of the prevalence and severity of pain and other symptoms in acute decompensated heart failure.J Palliat Med. 2013; 16: 87-90
- Evaluation of the prevalence and severity of pain in patients with stable chronic heart failure.World J Cardiol. 2012; 4: 250-255
- Heart failure: the hidden problem of pain.J Pain Symptom Manage. 2009; 38: 698-707
- A comparative study of pain in heart failure and non-heart failure veterans.J Card Fail. 2009; 15: 24-30
- Managing noncardiac pain in heart failure patients.J Cardiovasc Nurs. 2004; 19: S75-S83
- Palliative care in the management of patients with advanced heart failure.Adv Exp Med Biol. 2018; 1067: 295-311
- Differing effects of fatigue and depression on hospitalizations in men and women with heart failure.Am J Crit Care. 2016; 25: 526-534
- The relationship between pain, fatigue, depression and functional performance in stable heart failure.Heart Lung. 2015; 44: 107-112
- Health literacy and the patient with heart failure—implications for patient care and research: a consensus statement of the heart failure society of America.J Card Fail. 2010; 16: 9-16
- Older American key indicators of well-being.http://www.agingstats.gov(Accessed 11/28/2018)Date: 2016
- Systematic review and individual patient data meta-analysis of sex differences in depression and prognosis in persons with myocardial infarction: a MINDMAPS study.Psychoso Med. 2015; 77: 419-428
- Sexual dysfunction in heart failure patients.Curr Heart Fail Rep. 2014; 11: 330-336
- The prevalence and clinical relevance of sexual dysfunction in women and men with chronic heart failure.Int J Impot Res. 2008; 20: 85-91
- Sexual problems in elderly male and female patients with heart failure.Heart. 2012; 98: 1647-1652
Article info
Publication history
Published online: March 14, 2019
Accepted:
February 19,
2019
Received in revised form:
January 7,
2019
Received:
August 23,
2018
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.