title: Cluster analysis of symptoms in pulmonary arterial hypertension: a pilot study.
abstract: BACKGROUND
  Pulmonary arterial hypertension (PAH) is characterized by elevated pulmonary artery pressures leading to right heart failure and death.
  
  
  OBJECTIVE
  The aim of this study was to use cluster analysis to describe the symptom profile in PAH and differences in the health outcomes of health status, health-related quality of life (HRQoL) and psychological states in the cluster groups.
  
  
  METHODS
  A cross-sectional descriptive design was used. A convenience sample completed a socio-demographic and clinical data form, a PAH Symptom Severity and Interference Scale, the Medical Outcomes Study Short Form (SF-36), the United States Cambridge Pulmonary Hypertension Outcome Review (US CAMPHOR) and the Short Form of the Profile of Mood States (POMS).
  
  
  RESULTS
  Of the 151 participants, the mean age was 53.5 ± 15.1 with the majority female (n = 128, 85%). Fifty-eight (41%) were disabled and 67 (44%) were Functional Class IV. The most prevalent symptoms were shortness of breath with exertion (n = 149, 99%) and fatigue (n = 144, 93%). Three clusters emerged: Cluster 1 diffuse symptoms (n = 93), Cluster 2 severe cardiopulmonary symptoms (n = 32) and Cluster 3 moderate cardiopulmonary symptoms (n = 26). Overall, on the SF-36 the participants had poor general health, reduced physical function, role physical, vitality, and a low composite score for physical health. On the POMS the sample had limited vigor and increased fatigue. Cluster 2 Severe Cardiopulmonary Symptoms had worse SF-36, US CAMPHOR and POMS scores than the other cluster groups.
  
  
  CONCLUSIONS
  Patients with PAH are experiencing a constellation of symptoms that are interfering with their life and emerging clusters were present.
authors.affiliation: University of Pennsylvania, School of Nursing, 418 Curie Blvd., Philadelphia, PA 19104-4217, USA. matura@nursing.upenn.edu
authors.forename: Lea Ann
authors.initials: LA
authors.lastname: Matura
authors.forename: Annette
authors.initials: A
authors.lastname: McDonough
authors.forename: Diane L
authors.initials: DL
authors.lastname: Carroll
mesh_terms: D000328:Adult; D000368:Aged; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D065627:Familial Primary Pulmonary Hypertension; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D005260:Female; D006306:Health Surveys / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010865:Pilot Projects; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*