Exploring Symptom Clusters and Measurements in Patients with Heart Failure - A Scope Review

Background : Heart failure (HF) is a complex chronic condition characterized by diverse and overlapping symptom clusters across physiological, psychological, and social dimensions. However, the identification and assessment of symptom clusters in HF remain inconsistent, and the measurement tools used vary widely, limiting clinical symptom management and standardized care delivery. Aims : This scoping review aimed to identify the types of symptom clusters in patients with heart failure, evaluate the assessment tools used to measure these clusters, and explore the influencing factors affecting symptom severity, to support more effective clinical management Methods : The review followed the PRISMA-ScR guidelines. A systematic search was conducted across PubMed, Web of Science, and CNKI, including studies published up to January 2025. A total of 12 studies involving 9,328 patients were included. Data extraction and synthesis focused on symptom cluster types, assessment tools, and associated influencing factors. Results : Twelve studies were included, involving 9,328 patients, identifying 25 symptom clusters. Common symptom clusters included respiratory symptoms, fatigue-related symptoms, and psychological/emotional symptoms. The assessment tools primarily used were the MSAS-HF and MLHFQ, but differences in tool usage and inconsistency in the naming and classification of symptom clusters were observed. Conclusion : HF symptom clusters are diverse and inconsistently classified. Existing tools lack standardization. More precise and culturally adaptable assessment frameworks are needed. Implications for practice : Understanding symptom clusters and their assessment tools provides a foundation for developing standardized, culturally appropriate, and nurse-led symptom management strategies. This review offers practical insights to guide nurses in personalized assessment and care planning for heart failure patients.