Nurs Open. 2026 Jul;13(7):e70668. doi: 10.1002/nop2.70668.
ABSTRACT
AIM: To systematically evaluate the current state of research on symptom clusters in patients with chronic obstructive pulmonary disease (COPD) and the impact of identifying symptom clusters on health-related quality of life (HRQoL) outcomes.
DESIGN: A systematic review.
METHODS: Two reviewers independently screened the studies against the eligibility criteria. Studies were assessed for risk of bias using the Appraisal tool for Cross-Sectional Studies (AXIS tool). Data were extracted using a pre-developed extraction tool and thematically analysed.
DATA SOURCES: Databases searched included EMbase, PubMed, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database and China Science and Technology Journal Database. Searches were conducted from inception to June 12, 2025.
RESULTS: Eighteen studies were included. Symptom clusters were identified using two tool types, including four multi-symptom and 18 single symptom evaluation tools. Common symptom clusters are respiratory-related symptom cluster, psychological-related symptom cluster, sleep-related symptom cluster and fatigue-related symptom cluster. Seven studies found significant negative associations between symptom clusters and HRQoL. Six studies reported the negative effect of each symptom cluster on HRQoL, but only one study showed no association for the sleep-related cluster.
CONCLUSION: The study of COPD symptom clusters still lacked general evaluation tools and statistical methods. Robust studies are needed to deeply explore the differential impact of symptom clusters across various dimensions of HRQoL.
IMPLICATIONS FOR NURSING PRACTICE: Our findings may make symptom management strategies based on the perspective of symptom clusters possible. In clinical practice, nurses should prioritize identifying and intervening in the symptom clusters with the most significant impact on HRQoL, thereby promoting the transformation of the nursing model from ‘single-symptom management’ to ‘multi-symptom collaborative management.’
REPORTING METHOD: This study adheres to PRISMA and SWiM reporting guidelines.
PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Involvement because of the systematic review.
TRIAL REGISTRATION: PROSPERO: CRD42024606544.
PMID:42418728 | DOI:10.1002/nop2.70668
