Yao Qian, Luo Jian, Song Baomei, Yang Jin, Yuan Xiaorong, Li Xiuchuan, Tian Wei, Wang Tianyi, Zhu Bin, Yang Zheng
Chengdu Medical College, Chengdu, China.
The Third People's Hospital of Chengdu, Chengdu, China.
J Clin Nurs. 2025 Jul;34(7):2766-2778. doi: 10.1111/jocn.17475. Epub 2024 Oct 25.
Although heart failure (HF) symptoms affect patients' quality of life (QoL), improving patients' QoL requires certain self-care behaviours. However, the specific role of self-care behaviours in the relationship between HF symptoms and QoL has not been clarified.
To evaluate the status of symptom clusters, self-care behaviours and QoL in HF patients, and to analyse and test the moderating effect of self-care behaviours between symptom clusters and QoL.
This study is a cross-sectional study.
A total of 320 HF patients who treated in the three hospitals in Chengdu, China, from December 2022 to July 2023 were selected as the research subjects. The patients were evaluated using The General Information Questionnaire, Memorial Symptom Assessment Scale Heart Failure, Self-Care of Heart Failure Index and Minnesota Living with Heart Failure Questionnaire. The statistical analysis methods were exploratory factor analysis, Pearson correlation analysis, hierarchical regression analysis and simple slope analysis.
There were five symptom clusters in HF patients: emotional symptom cluster (sadness, anxiety, irritability, feeling nervous), digestive symptom cluster (lack of appetite, dry mouth, weight loss, nausea, abdominal distension), ischemic symptom cluster (dizziness, chest pain, palpitations, fatigue), dyspnoea symptom cluster (difficulty breathing when lying flat, waking up breathless at night, sleep difficulty) and congestion symptom cluster (cough, shortness of breath, oedema). There was a significant correlation between HF symptom group, self-care behaviours and QoL (p < 0.05). Both self-care maintenance (β = -0.262, p < 0.001) and self-care management (β = -0.258, p < 0.001) had a moderating effect between symptom clusters and QoL.
There are a variety of symptom clusters in HF patients. Improving the self-care behaviours ability of HF patients is conducive to reducing the impact of HF symptom clusters on QoL.
The study used the STROBE checklist for reporting.
Medical staff should focus on the impact of HF symptom clusters and self-care behaviours on QoL, and formulate corresponding interventions for HF symptom clusters and self-care behaviours to improve the QoL of patients.
The head nurse of the cardiovascular department actively assisted us in collecting questionnaires from HF patients, and all HF patients surveyed participated in this study seriously.
尽管心力衰竭（HF）症状会影响患者的生活质量（QoL），但改善患者的生活质量需要一定的自我护理行为。然而，自我护理行为在HF症状与生活质量之间的关系中所起的具体作用尚未明确。
评估HF患者症状群、自我护理行为和生活质量的状况，并分析和检验自我护理行为在症状群与生活质量之间的调节作用。
本研究为横断面研究。
选取2022年12月至2023年7月在中国成都三家医院接受治疗的320例HF患者作为研究对象。使用一般信息问卷、心力衰竭症状评估量表、心力衰竭自我护理指数和明尼苏达心力衰竭生活问卷对患者进行评估。统计分析方法包括探索性因素分析、Pearson相关分析、分层回归分析和简单斜率分析。
HF患者存在五个症状群：情绪症状群（悲伤、焦虑、易怒、紧张）、消化症状群（食欲不振、口干、体重减轻、恶心、腹胀）、缺血症状群（头晕、胸痛、心悸、疲劳）、呼吸困难症状群（平卧时呼吸困难、夜间惊醒气喘、睡眠困难）和充血症状群（咳嗽、气短、水肿）。HF症状群、自我护理行为和生活质量之间存在显著相关性（p < 0.05）。自我护理维持（β = -0.262，p < 0.001）和自我护理管理（β = -0.258，p < 0.001）在症状群与生活质量之间均具有调节作用。
HF患者存在多种症状群。提高HF患者的自我护理行为能力有助于减轻HF症状群对生活质量的影响。
本研究采用STROBE清单进行报告。
医护人员应关注HF症状群和自我护理行为对生活质量的影响，并针对HF症状群和自我护理行为制定相应干预措施，以提高患者的生活质量。
心血管内科护士长积极协助我们收集HF患者的问卷，所有接受调查的HF患者均认真参与了本研究。
