Symptom Clusters and Sentinel Symptoms in Heart Failure Patients: A Cross-Sectional Survey

To explore the symptom clusters of heart failure (HF) patients, identify the sentinel symptom of each symptom cluster, and provide a basis for the implementation of precise symptom management.

The study participants were recruited using convenience sampling from inpatients admitted to the cardiology department between November 2024 and January 2025, including patients admitted for acute HF, chronic HF, and acute decompensation of chronic HF. The General Information Questionnaire and the Memorial Symptom Assessment Scale were used for the survey. Symptom clusters were explored using principal component analysis, sentinel symptoms were explored using the Apriori algorithm.

A total of 354 HF patients participated in the study. Four symptom clusters were identified in HF patients: the nocturnal respiratory distress symptom cluster, the low perfusion symptom cluster, the upper airway irritation symptom cluster, and the gastrointestinal symptom cluster. Three sentinel symptoms were explored: waking up breathless at night, sweating and cough.

HF patients have a variety of symptoms in the form of four symptom clusters, waking up breathless at night, sweating and cough are the sentinel symptoms. Medical staff can take sentinel symptoms as the focus of symptom cluster evaluation and targeted intervention, which can improve the efficiency of symptom cluster management and reduce patients' symptom burden.