医学
荟萃分析
危险系数
心力衰竭
潜在类模型
内科学
认知
相对风险
星团(航天器)
生活质量(医疗保健)
物理疗法
置信区间
精神科
统计
数学
护理部
计算机科学
程序设计语言
作者
Chen Qiu,Doris S.F. Yu,Dan Song,Xiaobing Wang
摘要
Abstract Aim To determine the impact of symptom clusters on clinical outcomes among heart failure patients. Design Systematic review and meta‐analysis. Data sources Peer‐reviewed articles were searched from 12 English and Chinese language databases from inception to August 2021. Review Methods Narrative syntheses were first conducted to integrate symptom clusters reported in the identified studies. This was followed by meta‐analysis to synthesize the evidence on the association or predictive effects of symptom clusters on clinical outcomes. Results Twelve studies were identified. Among studies which identified highly correlated symptoms as in a cluster, meta‐analysis indicated that severe congestive ( r = .45, 95% CI = 0.38–0.52), weary ( r = .41, 95% CI = 0.33–0.50), ischaemic ( r = .29, 95% CI = 0.04–0.51) and stress‐related ( r = .62, 95% CI = 0.31–0.81) symptom clusters were correlated with a poorer health‐related quality of life. As for studies used latent class to identified patient cohorts of similar symptom pattern, high symptom cohorts (hazard ratio = 1.86, 95% CI = 1.39–2.48) and incongruent physical and psycho‐cognitive symptom cohorts was associated with a significantly higher risk (hazard ratio = 2.10, 95% CI = 1.44–3.07) of combined event rate relative to low symptom presentation. Conclusions This review has identified the impact of symptom clusters on clinical outcomes in heart failure patients. In addition to the classical physical symptoms highlighted in the clinical management guidelines, our findings suggested the important predictive role of psycho‐cognitive and weary symptoms in determining the clinical outcomes of HF patients. Impact This review concluded the promising prospect of symptom clusters in shaping clinical outcomes of heart failure. The findings highlighted the importance of integrating care to minimize the disease impact on psycho‐cognitive function and weary symptoms among this clinical cohort. The review also inform the direction on how to advance the knowledge on symptom clusters among this clinical cohort.
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