Systematic review of symptom clusters in cardiovascular disease

Authors

Holli A. DeVon, The University of Illinois at ChicagoFollow
Karen Vuckovic, The University of Illinois at Chicago
Catherine J. Ryan, The University of Illinois at Chicago
Susan Barnason, University of Nebraska - LincolnFollow
Julie J. Zerwic, The University of Illinois at Chicago
Bunny J. Pozehl, University of Nebraska - LincolnFollow
Paula Schulz, University of Nebraska - LincolnFollow
Yaewon Seo, University of Nebraska - Lincoln
Lani Zimmerman, University of Nebraska - LincolnFollow

Date of this Version

2016

Document Type

Article

Citation

European Journal of Cardiovascular Nursing (2016), 12pp

Comments

Copyright © 2016 The European Society of Cardiology

doi 10.1177/1474515116642594

Abstract

Background: Although individual symptoms and symptom trajectories for various cardiovascular conditions have been reported, there is limited research identifying the symptom clusters that may provide a better understanding of patients’ experiences with heart disease. Aims: To summarize the state of the science in symptom cluster research for patients with acute coronary syndrome, myocardial infarction, coronary artery bypass surgery, and heart failure through systematic review and to provide direction for the translation of symptom cluster research into the clinical setting. Methods: Databases were searched for articles from January 2000 through to May 2015 using MESH terms “symptoms, symptom clusters, acute coronary syndrome (ACS), myocardial infarction (MI), coronary heart disease (CHD), ischemic heart disease (IHD), heart failure (HF), coronary artery bypass surgery (CABS), cluster analyses, and latent classes.” The search was limited to human studies, English language articles, and original articles investigating symptom clusters in individuals with heart disease. Fifteen studies meeting the criteria were included. Results: For patients with ACS and MI, younger persons were more likely to experience clusters with the most symptoms. Older adults were more likely to experience clusters with the lowest number of symptoms and more diffuse and milder symptom clusters that are less reflective of classic ACS presentations. For HF patients, symptom clusters frequently included physical and emotional/cognitive components; edema clustered in only three studies. Symptom expression was congruent across geographical regions and cultures. Conclusions: The findings demonstrated similarities in symptom clusters during ACS, MI, and HF, despite multiple methods and analyses. These results may help clinicians to prepare at-risk patients for proper treatment-seeking and symptom self-management behaviors.