Symptom clusters and quality of life among patients with advanced heart failure

Objectives To identify symptom clusters among patients with advanced heart failure （HF） and the independent relationships with their quality of life （QoL）. Methods This is the secondary data analysis of a cross-sectional study which interviewed 119 patients with advanced HF in the geriatric unit of a regional hospital in Hong Kong. The symptom profile and QoL were assessed by using the Edmonton Symptom Assessment Scale （ESAS） and the McGill QoL Questionnaire. Exploratory factor analysis was used to identify the symptom clusters. Hier- archical regression analysis was used to examine the independent relationships with their QoL, after adjusting the effects of age, gender, and comorbidities. Results The patients were at an advanced age （82.9± 6.5 years）. Three distinct symptom clusters were identified： they were the distress cluster （including shortness of breath, anxiety, and depression）, the decondition cluster （fatigue, drowsiness, nausea, and reduced appetite）, and the discomfort cluster （pain, and sense of generalized discomfort）. These three symptom clusters accounted for 63.25% of variance of the patients＇ symptom experience. The small to moderate correlations between these symptom clusters indicated that they were rather independent of one another. After adjusting the age, gender and comorbidities, the distress （β = -0.635, P 〈 0.001）, the decondition （β = -0.148, P = 0.01）, and the discomfort （β = -0.258, P 〈 0.001） symptom clusters independently predicted their QoL. Conclusions This study identified the distinctive symptom clusters among patients with advanced HF. The results shed light on the need to develop palliative care interventions for optimizing the symptom control for this life-limiting disease.

A Review of the Research on Symptom Clusters in Cancer Survivors

Cancer survivors often experience multisymptom clusters, substantial discomfort and lower QOL (quality of life) than the general population. This article summarized the progress of the research on symptom clusters in cancer survivors, and reviewed the definitions, influencing factors, and identified approaches and interventions regarding symptom clusters. The findings allow recommendations to be made in clinical nursing to improve the QOL of cancer survivors. In future studies, longitudinal, large-sample and multicenter studies are recommended to obtain more in-depth information about the changes in symptom and symptom cluster experience perceived by groups of cancer survivors.

Global trends and knowledge-relationship of symptom clusters in cancer research:a bibliometric analysis over the past 20 years

Objective:To use Cite Space and VOSviewer to investigate the scientific production in the field of symptom clusters in cancer research.Methods:The search was performed using the terms“symptom clusters,”“cancer,”and“oncology”on the Web of Science Core Collection database.The retrieval time was from 2001 to 2021,which covers the last 2 decades.Based on the production theory of scientific knowledge and the data mining of citations,data pertaining to the annual publications,journals,countries,organizations,authors,and keywords that produce symptom clusters in cancer research,as well as their cooperation(collaboration network),were extracted,and then both were clarified by the software tools VOSviewer(version 1.6.16)and Cite Space(version 6.1.R2).Results:A total of 1796 publications were retrieved between 2001 and 2021,and 473 relevant publications were included after screening.The results showed an increasing trend in published articles.The United States had the largest number of publications(261/473,55.18%),followed by China and Canada.The University of California,San Francisco,was the most productive institution.Current research hotspots included the analysis of symptom clusters and symptom management in patients with breast cancer and lung cancer,as well as any advanced cancer and cancer cachexia;fatigue-related symptom clusters and depression-anxiety symptom cluster;and the impacts of symptom clusters on quality of life.The research frontiers included analysis between health-related quality of life and symptom clusters,data mining in symptom clusters,research on the mental health status of cancer patients,and study of the mechanism and biological pathways of symptom clusters.Conclusions:The study provides insight into the global research perspective for the scientific progress on cancer symptom clusters,which suggests a growing scientific interest in this field,and more studies are warranted to guide symptom management.

Effective management for older people with heart failure： from acute to palliative care paradigms

Heart failure （HF） had emerged as an epidemic since two decades ago and is now a major threatening public health problem affecting 23 million population worldwide,

Symptom clustering in chronic gastritis based on spectral clustering

OBJECTIVE: Apply spectral clustering to analyze the patterns of symptoms in patients with chronic gastritis(CG).METHODS: Based on 919 CG subjects, we applied mutual information feature selection to choose the positively correlated symptoms with each pattern.Then, we used the Shi and Malik spectral clustering algorithm to select the top 20 correlated symptoms.RESULTS: We ascertained the results of six patterns.There were three categories for the pattern of accumulation of damp heat in the spleen-stomach(0.00332). There were six categories for the pattern of dampness obstructing the spleen-stomach(0.02466). There were two categories for the pattern of spleen-stomach Qi deficiency(0.013 89).There were three categories for the pattern of spleen-stomach deficiency cold(0.009 15). There were five categories for the pattern of liver-Qistagnation(0.01910).There were four categories for the pattern of stagnant heat in the liver-stomach(0.00585).CONCLUSION: Most of the spectral clustering results of the symptoms of CG patterns were in accordance with clinical experience and Traditional Chinese Medicine theory. Most categories suggested the nature and/or location of the disease.

A quantification model of Traditional Chinese Medicine syndromes in children with idiopathic precocious puberty and early puberty

OBJECTIVE:To establish a quantification model of Traditional Chinese Medicine(TCM)syndromes by sampling patients undergoing idiopathic precocious puberty(IPP)and early puberty.METHODS:A questionnaire for classifying and quantifying TCM syndromes was designed and administered.All the results were analyzed;the relationship between 3 types of syndrome and 47symptoms were summated.Meanwhile,the frequency distribution of each symptom or sign was aggregated.Fuzzy mathematics was used to develop a quantification model ofTCM syndromes.RESULTS:We found that precocious puberty had 3types of syndrome,including hyperactivity of fire due to Yin deficiency(Syndrome I),depressed liver Qi transforming into fire(Syndrome II),and end retention of damp heat(Syndrome III).In the IPP group,Syndrome I was the most common principal syndrome(100%).Forty-six patients(43.81%)werediagnosed with Syndrome I accompanied by Syndrome II and 11(10.48%)were diagnosed with Syndrome I accompanied by Syndrome III.In the early puberty group,Syndrome I was also the main syndrome(98.39%).The degrees of most symptoms were mild to moderate.Reddened tongue was the most common tongue manifestation(62.86%prevalence)in the IPP group.The most common pulse manifestations were slippery pulse,thread pulse,and taut pulse.The Asymptotic Normalization Coefficient(ANC)method was used to quantify the TCM syndromes in 167 cases.Diagnostic accuracy rate reached 91%,comparable to expert diagnosis.CONCLUSION:We find that there are 3 types of syndrome in the IPP group and in the early puberty group.Syndrome I(hyperactivity of fire due to Yin deficiency)is the main syndrome in the two groups.ANC may be an appropriate for quantification model ofTCM syndromes.