Functional Capacity, Functional Performance, and Symptoms in People With Heart Failure: An Integrative Review

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Clinical Psychology

Background:

• Heart failure (HF) significantly impacts patients' functional status, affecting their ability to perform daily activities.
• Existing research often conflates functional capacity and performance, with limited focus on symptom contributions in HF.

Purpose of the Study:

• To systematically review and synthesize literature on the relationship between symptoms, functional capacity, and functional performance in individuals with heart failure.

Main Methods:

• An integrated review of 23 observational studies involving 7219 participants (age 40-86) with heart failure.
• Studies examined relationships between symptoms (dyspnea, fatigue, pain, insomnia, depression, anxiety) and functional capacity/performance measures.
• Joanna Briggs Institute critical appraisal tools were used for quality assessment.

Main Results:

• Functional capacity, often measured by the Six-Minute Walk Test, showed inverse associations with pain, insomnia, and psychological symptoms.
• Functional performance, assessed via NYHA class and SF-36, correlated with sleep difficulties, fatigue, depression, and anxiety.
• Depressive symptoms, fatigue, pain, and insomnia were linked to decreased functional performance and capacity in HF patients.

Conclusions:

• Symptoms in heart failure commonly correlate with diminished functional status, but findings vary based on assessment metrics.
• The distinct relationships between symptoms and functional capacity versus performance underscore conceptual differences.
• Future research should carefully select functional status dimensions and measures aligned with study objectives and resources.