Identification of symptom clusters,core symptoms,and bridge symptoms in patients with chronic heart failure

WU Jieyi; YU Miao; QIU Aihua; YE Zengjie; ZHOU Dan; LIU Xiaobu; CHEN Enni

doi:10.12104/j.issn.1674-4748.2025.19.007

Abstract：Objective:To identify the symptom clusters of patients with chronic heart failure(CHF)and construct a symptom network to explore the core symptoms and bridge symptoms.Methods:A total of 342 CHF patients who visited a tertiary grade A level Chinese medicine hospital from September 2022 to December 2023 were selected as the research subjects by using a convenience sampling method.The general information questionnaire and the Chinese version of the Memorial Symptom Assessment Scale-Heart Failure(MSAS-HF)were used to investigate the patients.Exploratory factor analysis was used to extract the symptom clusters.The concurrent symptom network was constructed using R software,and the centrality index was calculated.Results:Five symptom clusters were extracted by exploratory factor analysis:the sickness symptom cluster,the sleep-digestion symptom cluster,the dyspnea symptom cluster,the mental and psychological symptom cluster,and the peripheral congestion symptom cluster.The top three symptoms of node strength centrality are sweating(rs=1.918),waking up from sleep at night(rs=1.167),and difficulty concentrating(rs=0.099).The top three symptoms of bridge strength centrality are waking up from sleep at night(rbs=4.418),abdominal distension(rbs=4.183),and easy sleepiness(rbs=4.093).Conclusions:The core symptom of CHF patients is sweating,and waking up from sleep at night,abdominal distension and easy sleepiness play a major bridging role between symptom clusters.Medical staff should develop precise intervention plans based on relevant target symptoms to improve the efficiency of symptom management.