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Zheng Y, Chen Q, Xia C, Liu H. Thirst symptoms in patients with heart failure: An integrative review. J Adv Nurs 2024. [PMID: 38771082 DOI: 10.1111/jan.16250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/29/2024] [Accepted: 05/10/2024] [Indexed: 05/22/2024]
Abstract
AIM To identify the risk and protective factors affecting thirst symptoms in patients with heart failure (HF) and intervention strategies to alleviate thirst symptoms. DESIGN An integrative review. METHODS A total of 61 articles were retrieved. Screening yielded a total of 21 articles which were appraised for quality. The quality of studies was assessed using the Mixed Methods Appraisal Tool. DATA SOURCES Ten electronic databases were searched in October 2023, including Embase, Pubmed, CINAHL, Cochrane, Web of Science, Wiley, CNKI, VIP, CBM and WanFang. In addition, we searched grey databases and manually searched reference lists of included and relevant reviews. RESULTS In total, 1644 articles were retrieved, of which 21 were included. Eight studies addressed the factors. Six themes emerged as risk factors, including demographics, severity of disease, psycho-environmental, medication, fluid restriction and homeostasis. Conversely, an increase in fluid intake, a high score of sodium restriction diet attitude and using ARB were identified as protective factors. Thirteen studies focus on intervention strategies. Five unique intervention strategies were identified, including Traditional Chinese Medicine, mint-related interventions, sour-flavour interventions, improved water restriction and cluster nursing strategy. CONCLUSION This finding identified the factors associated with thirst symptoms in patients with HF, especially concerning the elaboration of risk factors, which suggests that healthcare professionals should focus on the risk factors for thirst in patients with HF and consciously avoid the occurrence of these risk factors. Additionally, there are considerable cultural differences in interventions, therefore, to increase adherence during symptom management, careful selection of appropriate intervention strategies based on the requirements and preferences of patients is required. While there are some therapies, there aren't enough high-quality empirical investigations. Thus, multi-centre, large-sample studies are also required in subsequent research to demonstrate the interventions' effectiveness. IMPLICATIONS FOR THE PROFESSION The nurse must notice the symptoms of thirst in HF to slow down the disease's progression and improve the patient's physical and emotional well-being. REPORTING METHOD The review complies with the PRISMA guidelines for reporting systematic reviews. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Yingjun Zheng
- Shantou University Medical College, Shantou, Guangdong Province, China
- The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Qiongshan Chen
- Shantou University Medical College, Shantou, Guangdong Province, China
- The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Chengyu Xia
- Shantou University Medical College, Shantou, Guangdong Province, China
- The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Hui Liu
- The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
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Gocay Bek SG, Yıldız N, Islam M, Ergul M, Sarıoglu I, Guven Taymez D, Eren N, Uslu H, Tosun M, Dervisoglu E, Kalender B, Balcı S, Waldreus N. Thirst intensity survey in ADPKD patients. Clin Exp Nephrol 2023; 27:819-827. [PMID: 37351680 DOI: 10.1007/s10157-023-02373-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/14/2023] [Indexed: 06/24/2023]
Abstract
INTRODUCTION With increased fluid intake and tolvaptan treatment, the growth rate of cysts can be theoretically decelerated in autosomal polycystic kidney disease. In this prospective study, it was planned to evaluate thirst sensation in these patients and the parameters affecting its intensity. METHODS Forty-one ADPKD patients on tolvaptan and 40 ADPKD patients not on tolvaptan as the control group were evaluated for thirst distress sensation and intensity. The feeling of thirst and the discomfort caused by excessive fluid intake was assessed with Thirst Distress Scale-HF 12 questions (60/12). Thirst intensity was evaluated with a 100 mm visual scale. RESULTS Of the whole group, 35.8% (29) were males, and 64.2% (52) were females. The mean age of the tolvaptan group was 39.17 ± 9.35 years and for the control group, it was 41.95 ± 12.29 years. There was a negative correlation between the thirst distress score of the patients and an increase in creatinine level after a year of tolvaptan treatment (r = - 0.335, p = 0.035). The patients not taking thiazide had higher thirst intensity scores (p = 0.004). There was no impact of tolvaptan dosage, total kidney volume, serum sodium, urinary osmolarity or eGFR on thirst distress and thirst intensity scores. DISCUSSION/CONCLUSION Only thiazide co-treatment had a positive impact on thirst distress and intensity when given tolvaptan. Thirst Distress Scale for ADPKD patients can be used to classify patients before and during tolvaptan treatment.
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Affiliation(s)
- Sibel Gokcay Gocay Bek
- Department of Nephrology, Kocaeli University Hospital, Umuttepe, Kocaeli, 41100, Turkey.
| | - Nuriye Yıldız
- Department of Nephrology, Kocaeli University Hospital, Umuttepe, Kocaeli, 41100, Turkey
| | - Mahmud Islam
- Department of Nephrology, Sakarya University, Sakarya, Turkey
| | - Metin Ergul
- Department of Nephrology, Kocaeli University Hospital, Umuttepe, Kocaeli, 41100, Turkey
| | - Irem Sarıoglu
- Department of Internal Medicine, Kocaeli University Hospital, Kocaeli, Turkey
| | | | - Necmi Eren
- Department of Nephrology, Kocaeli University Hospital, Umuttepe, Kocaeli, 41100, Turkey
| | - Hande Uslu
- Department of Radiology, Kocaeli University Hospital, Kocaeli, Turkey
| | - Mesude Tosun
- Department of Radiology, Kocaeli University Hospital, Kocaeli, Turkey
| | - Erkan Dervisoglu
- Department of Nephrology, Kocaeli University Hospital, Umuttepe, Kocaeli, 41100, Turkey
| | - Betul Kalender
- Department of Nephrology, Kocaeli University Hospital, Umuttepe, Kocaeli, 41100, Turkey
| | - Sibel Balcı
- Department of Biostatistics and Medical Informatics, Kocaeli University Hospital, Kocaeli, Turkey
| | - Nana Waldreus
- Department of Neurobiology, Care Sciences and Society, Karollinska Institute, Huddinge, Sweden
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Chen Y, Ding J, Xi Y, Huo M, Mou Y, Song Y, Zhou H, Cui X. Thirst in heart failure: A scoping review. Nurs Open 2023; 10:4948-4958. [PMID: 37247329 PMCID: PMC10333895 DOI: 10.1002/nop2.1818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/24/2023] [Accepted: 05/04/2023] [Indexed: 05/31/2023] Open
Abstract
AIM The aim of this study was to summarise the overall picture of thirst-related research in patients with heart failure. DESIGN We conducted a scoping review following the Arskey and O'Malley methodological framework along with the PAGER framework. METHODS PubMed, CINAHL, Web of Science, Embase, The Cochrane Library, Jonna Briggs Institute, ProQuest Database, Google Scholar, PsycINFO, PQDT, CNKI, Wan Fang, VIP and CBM. Additionally, grey literature including grey databases (Opengrey, OpenDoar, Openaire and BASEL Bielefeld Academic Search Engine), conferences or articles (Scopus and Microsoft Academic), graduate theses databases (eTHOS, DART Europe, Worldcat and EBSCO Open Dissertations) and government information media (UK guidance and regulations, USA government websites, EU Bookshop and UN official publications) were searched. The databases were searched from inception to 18 August 2022 for Articles written in English and Chinese. Two researchers independently screened articles based on inclusion and exclusion criteria, and a third researcher adjudicated disagreements. RESULTS We retrieved 825 articles, of which 26 were included. Three themes were summarised from these articles: (a) the incidence of thirst in patients with heart failure; (b) the thirst-related factors in patients with heart failure; and (c) the intervention measures of thirst in patients with heart failure.
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Affiliation(s)
- Yaya Chen
- Department of NursingGansu University of Chinese MedicineLanzhouGansuChina
- Cardiovascular DepartmentThe First People's Hospital of Li CountyLixianGansuChina
| | - Jin Ding
- Cardiovascular CenterAffiliated Hospital of Gansu University of Traditional Chinese MedicineLanzhouGansuChina
| | - Yingbo Xi
- Cardiovascular CenterAffiliated Hospital of Gansu University of Traditional Chinese MedicineLanzhouGansuChina
| | - Minfeng Huo
- Department of Basic MedicineGansu University of Chinese MedicineLanzhouGansuChina
| | - Yingjian Mou
- Cardiovascular DepartmentThe First People's Hospital of Li CountyLixianGansuChina
| | - Yu Song
- Department of NursingGansu University of Chinese MedicineLanzhouGansuChina
| | - Hailing Zhou
- Department of NursingGansu University of Chinese MedicineLanzhouGansuChina
- Cardiovascular CenterAffiliated Hospital of Gansu University of Traditional Chinese MedicineLanzhouGansuChina
| | - Xiaoqin Cui
- Department of NursingGansu University of Chinese MedicineLanzhouGansuChina
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Durst und Trinken – Physiologie und Bedeutung für die Störungen des Wasserhaushalts. JOURNAL FÜR KLINISCHE ENDOKRINOLOGIE UND STOFFWECHSEL 2022. [DOI: 10.1007/s41969-022-00179-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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van der Wal MHL, Jaarsma T, Jenneboer LC, Linssen GCM. Thirst in stable heart failure patients; time to reconsider fluid restriction and prescribed diuretics. ESC Heart Fail 2022; 9:2181-2188. [PMID: 35546481 PMCID: PMC9288740 DOI: 10.1002/ehf2.13960] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 01/28/2023] Open
Abstract
Aims One of the bothersome symptoms that heart failure (HF) patients can experience is thirst. There are limited data on the association between thirst and fluid intake and clinical variables. Therefore, the aim of this study was to describe severe thirst in stable HF patients and assess factors related to severe thirst, including actual fluid intake and sodium intake. Methods and results The study had a cross‐sectional design. Stable HF patients from two HF clinics in the Netherlands were included and assessed thirst by a visual analogue scale ranging from 0 to 100. They also completed questionnaires on thirst distress, self‐care behaviour, and HF symptoms. A 3 day food diary was completed to assess actual fluid intake and sodium intake. Finally, patients collected urine for 24 h. Patients were divided into severe and low thirst based on thirst score and thirst distress. T‐tests, Mann–Whitney tests, and χ2 tests were conducted to assess differences between both groups. Multivariable logistic regression analysis was performed to assess factors associated with severe thirst. A total of 100 patients were included (40% female, mean age 72 ± 12) of which 68 completed the food diary. The mean thirst score was 28 ± 25, and 25% experienced severe thirst. The majority of patients (94%) were prescribed a fluid restriction, 37% had a restriction between 1500 and 2000 mL, and 32% a restriction of 1500 mL. Severe thirst in the total group with 100 patients was associated with a higher dose of loop diuretics [odds ratio (OR) 3.25; 95% confidence interval (CI) 1.01–10.45; P = 0.048] and a higher urine output over 24 h (OR 1.002; 95% CI 1.00–1.003; P = 0.010). In the group of patients who completed the food diary (N = 68), severe thirst was associated with a higher sodium intake (OR 1.002; 95% CI 1.001–1.003; P = 0.003), a higher dose of loop diuretics (OR 22.69; 95% CI 2.78–185.04; P = 0.004), and more fatigue (OR 11.2; 95% CI 1.54–82.12; P = 0.017). Conclusions A quarter of all stable HF patients experienced severe thirst. A higher dose of loop diuretics was associated with more thirst; therefore, it might be important to review the dose of loop diuretics critically and try to decrease it in order to relieve severe thirst. Because all patients were prescribed a fluid restriction, a reconsideration of this restriction is also suggested.
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Affiliation(s)
- Martje H L van der Wal
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden.,Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Gerard C M Linssen
- Department of Cardiology, Hospital Group Twente (Almelo and Hengelo), Almelo, The Netherlands
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Eng SH, Waldréus N, González B, Ehrlin J, Díaz V, Rivas C, Velayos P, Puertas M, Ros A, Martín P, Lupón J, Bayes-Genis A, Jaarsma T. Thirst distress in outpatients with heart failure in a Mediterranean zone of Spain. ESC Heart Fail 2021; 8:2492-2501. [PMID: 33942551 PMCID: PMC8318476 DOI: 10.1002/ehf2.13395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/23/2021] [Accepted: 04/21/2021] [Indexed: 12/14/2022] Open
Abstract
Aims This study aimed to evaluate psychometric properties of the Spanish version of the Thirst Distress Scale for patients with Heart Failure (TDS‐HF) and to describe thirst distress‐associated factors in outpatients at a heart failure (HF) clinic in Spain. Thirst is common in patients with HF, but thirst distress has rarely been addressed and may significantly decrease quality of life. Methods and results A cross‐sectional study was performed assessing perceived thirst distress by patients with HF during the preceding 3 days, with the TDS‐HF (scores 8 to 40). Univariable and multivariable linear regression analyses were performed to identify variables independently associated with thirst distress. Three‐hundred two HF outpatients were included (age 67 ± 12 years, 74% male, HF duration 82 ± 75 months, left ventricular ejection fraction 42 ± 14%). Most patients were on treatment with fluid restriction (99%), sodium restriction (99%), and diuretics (70%). The psychometric evaluation of the Spanish version of the TDS‐HF showed satisfactory item‐total and inter‐item correlations (range from 0.77 to 0.85 and 0.60 to 0.84, respectively), and internal consistency was 0.95 (Cronbach's alpha). The majority perceived mild to moderate thirst distress, and 18% perceived it as high or severe. The mean score obtained was 16.2 ± 9.3 (median 13, Q1–Q3 8–20). Higher serum urea {beta coefficient 1.6 [95% confidence interval (CI) 0.267 to 2.92], P = 0.019} and lower potassium [beta coefficient −3.63 (85% CI −6.32 to −0.93), P = 0.009] remained significantly associated with thirst distress in the multivariable analysis, together with the dose of diuretics [beta coefficient 2.98 (95% CI 1.37 to 4.59), P < 0.001]. Treatment with angiotensin receptor blocker showed an independent protective effect [beta coefficient −3.62 (95% CI −6.89 to −0.345), P = 0.03]. Conclusions The psychometric evaluation of the Spanish version of the TDS‐HF showed good psychometric properties. One in five patients experienced severe distress by thirst, but the majority had mild to moderate thirst distress. The dose of diuretics and angiotensin receptor blocker treatment influence thirst distress and could be clinically important targets to relieve thirst distress in patients with HF.
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Affiliation(s)
- Sanna Hagelberg Eng
- Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Nana Waldréus
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Theme Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Beatriz González
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain
| | - Jenny Ehrlin
- Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Violeta Díaz
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain
| | - Carmen Rivas
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain
| | - Patricia Velayos
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain
| | - María Puertas
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain
| | - Alba Ros
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain
| | - Paula Martín
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain
| | - Josep Lupón
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
| | - Antoni Bayes-Genis
- Heart Failure Unit, Hospital Universitary Germans Trias i Pujol, Badalona, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain
| | - Tiny Jaarsma
- Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
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