Streur Megan, Ratcliffe Sarah J, Ball Jocasta, Stewart Simon, Riegel Barbara
Megan Streur, RN, MN Doctoral Student, School of Nursing, University of Pennsylvania, Philadelphia. Sarah J. Ratcliffe, PhD Associate Professor, Division of Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia. Jocasta Ball, PhD Postdoctoral Research Fellow, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. Simon Stewart, PhD, RN Professor, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia. Barbara Riegel, PhD, RN Professor, School of Nursing, University of Pennsylvania, Philadelphia.
J Cardiovasc Nurs. 2017 May/Jun;32(3):296-303. doi: 10.1097/JCN.0000000000000344.
Symptom clusters have not previously been explored among individuals with atrial fibrillation of any type.
The purpose of this study is to determine the number of symptom clusters present among adults with chronic atrial fibrillation and to explore sociodemographic and clinical factors potentially associated with cluster membership.
This was a cross-sectional secondary data analysis of 335 Australian community-dwelling adults with chronic (recurrent paroxysmal, persistent, or permanent) atrial fibrillation. We used self-reported symptoms and agglomerative hierarchical cluster analysis to determine the number and content of symptom clusters present.
There were slightly more male (52%) than female participants, with a mean (SD) age of 72 (11.25) years. Three symptom clusters were evident, including a vagal cluster (nausea and diaphoresis), a tired cluster (fatigue/lethargy, weakness, syncope/dizziness, and dyspnea/breathlessness), and a heart cluster (chest pain/discomfort and palpitations/fluttering). We compared patient characteristics among those with all the symptoms in the cluster, those with some of the symptoms in the cluster, and those with none of the symptoms in the cluster. The only statistically significant differences were in age, gender, and the use of antiarrhythmic medications for the heart cluster. Women were more likely to have the heart symptom cluster than men were. Individuals with all of the symptoms in the heart cluster were younger (69.6 vs 73.7 years; P = .029) than those with none of the symptoms in the heart cluster and were more likely to be on antiarrhythmic medications.
Three unique atrial fibrillation symptom clusters were identified in this study population.
此前尚未在任何类型心房颤动患者中探究症状群。
本研究旨在确定慢性心房颤动成年患者中存在的症状群数量，并探究可能与症状群归属相关的社会人口学和临床因素。
这是一项对335名患有慢性（复发性阵发性、持续性或永久性）心房颤动的澳大利亚社区成年居民进行的横断面二次数据分析。我们使用自我报告的症状和凝聚层次聚类分析来确定存在的症状群数量和内容。
男性参与者（52%）略多于女性，平均（标准差）年龄为72（11.25）岁。明显存在三个症状群，包括迷走神经症状群（恶心和多汗）、疲劳症状群（疲劳/无精打采、虚弱、晕厥/头晕和呼吸困难/呼吸急促）和心脏症状群（胸痛/不适和心悸/扑动）。我们比较了症状群中所有症状患者、部分症状患者和无任何症状患者的特征。唯一具有统计学显著差异的是年龄、性别以及心脏症状群中抗心律失常药物的使用情况。女性比男性更有可能出现心脏症状群。心脏症状群中出现所有症状的个体比心脏症状群中无任何症状的个体更年轻（69.6岁对73.7岁；P = 0.029），且更有可能服用抗心律失常药物。
本研究人群中识别出了三个独特的心房颤动症状群。
