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Effectiveness of symptom perception interventions among patients with heart failure: a systematic review and

Xiangyu Wang^1,2, Guangju Wang^1,2, Yichen Liu^1,2

¹Department of Nursing, The First Affiliated Hospital of Soochow University, Suzhou, China.

Frontiers in Cardiovascular Medicine

|March 12, 2026

Abstract

Background:

Although symptom perception appears promising for enhancing health-related quality of life in patients with heart failure (HF), no quantitative pooling of effect sizes has been described to summarize and test its efficacy on clinical outcomes. This systematic review and meta-analysis aimed to determine the effect of symptom perception interventions on HF patients' symptom perception (primary outcome), self-care, HF knowledge, self-care efficacy, quality of life, rehospitalisation, emergency department visits, and mortality (secondary outcomes).

Methods:

We systematically searched four databases: PubMed, Embase, the Cochrane Library, and CINAHL, from inception to March 31, 2025. RCT studies exploring the effectiveness of symptom perception interventions among HF patients were included. The studies were independently screened and extracted by two reviewers. ROB2 was applied to assess risk bias. A meta-analysis was performed using STATA 17.0.

Results:

Eight articles involving a total of 1030 patients were included. Pooled results showed that for HF patients, symptom perception interventions failed to decrease rehospitalization, emergency department visits and mortality. However, such interventions significantly improved patients' immediate post-intervention outcomes, including symptom perception (SMD: 0.579, 95% CI: 0.259-0.898, P = 0.000), self-care (SMD: 0.697, 95% CI: 0.436-0.959, P = 0.000), HF knowledge (SMD: 1.481, 95% CI: 0.270-2.692, P = 0.017), self-care efficacy (MD: 7.875, 95% CI: 1.054-14.695, P = 0.024), and ultimately enhanced quality of life (MD: -8.240, 95% CI: -16.088 to -0.392, P = 0.040).

Conclusion:

The review suggests that symptom perception interventions can improve HF patients' symptom perception, self-care, HF knowledge, self-care efficacy, and quality of life, although they do not reduce rehospitalization, emergency department visits, or mortality. The findings provide a basis for optimizing symptom perception intervention plans for future researchers.

Systematic Review Registration:

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251035486, PROSPERO CRD420251035486.

Keywords:

RCT heart failure intervention meta-analysis symptom perception

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