SYSTEMATIC REVIEW article
Front. Cardiovasc. Med.
Sec. Heart Failure and Transplantation
Effectiveness of symptom perception interventions among patients with heart failure: A systematic review and meta-analysis
Xiangyu Wang 1,2
Guangju Wang 1,2
Yichen Liu 1,2
Liwen Xia 1,2
Yingnan Zhao 1
Lifen Mao 1
Xiaoqing Shi 1
Rulan Yin 1
1. First Affiliated Hospital of Soochow University, Suzhou, China
2. School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China
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Abstract
Background: Although symptom perception appears promising for enhancing health-related quality of life in patients with heart failure (HF), no quantitative pooling of effect sizes has been described to summarize and test its efficacy on clinical outcomes. This systematic review and meta-analysis aimed to determine the effect of symptom perception interventions on HF patients' symptom perception (primary outcome), self-care, HF knowledge, self-care efficacy, quality of life, rehospitalisation, emergency department visits, and mortality (secondary outcomes). Methods: We systematically searched four databases: PubMed, Embase, the Cochrane Library, and CINAHL, from inception to March 31, 2025. RCT studies exploring the effectiveness of symptom perception interventions among HF patients were included. The studies were independently screened and extracted by two reviewers. ROB2 was applied to assess risk bias. A meta-analysis was performed using STATA 17.0. Results: Eight articles involving a total of 1030 patients were included. Pooled results showed that for HF patients, symptom perception interventions failed to decrease rehospitalization, emergency department visits and mortality. However, such interventions significantly improved patients' immediate post-intervention outcomes, including symptom perception (SMD: 0.579, 95% CI: 0.259 to 0.898, P=0.000), self-care (SMD: 0.697, 95% CI: 0.436 to 0.959, P=0.000), HF knowledge (SMD: 1.481, 95% CI: 0.270 to 2.692, P=0.017), self-care efficacy (MD: 7.875, 95% CI: 1.054 to 14.695, P=0.024), and ultimately enhanced quality of life (MD: -8.240, 95% CI: -16.088 to -0.392, P=0.040) Conclusion: The review suggests that symptom perception interventions can improve HF patients' symptom perception, self-care, HF knowledge, self-care efficacy, and quality of life, although they do not reduce rehospitalization, emergency department visits, or mortality. The findings provide a basis for optimizing symptom perception intervention plans for future researchers. Systematic Review Registration: PROSPERO CRD420251035486.
Summary
Keywords
Heart Failure, intervention, Meta-analysis, rct, Symptom perception
Received
15 September 2025
Accepted
09 February 2026
Copyright
© 2026 Wang, Wang, Liu, Xia, Zhao, Mao, Shi and Yin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Rulan Yin
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