Research trends and hot topics in Nursing studies on symptom management in heart failure: a bibliometric analysis

Abstract

Heart failure is a complex chronic condition characterized by a high symptom burden that significantly affects patients’ physical, psychological, and social well-being. Nurses play a central role in symptom assessment and management; however, the rapid growth of the literature makes it challenging to identify dominant research themes, influential studies, and emerging gaps. A bibliometric overview can provide a comprehensive understanding of the knowledge structure and research trends in this field. Purpose: This study aimed to map the scientific literature on nursing studies focused on symptom management in heart failure, identify research trends and hot topics, and highlight knowledge gaps to inform future research and clinical practice. Methods: A bibliometric analysis was conducted using the Web of Science database, including original research articles published in English within the last five years and indexed in the nursing category. After applying inclusion and exclusion criteria, 3,602 articles were analyzed. Bibliometric indicators were examined using the Bibliometrix package in R and VOSviewer. Performance analysis, keyword co-occurrence analysis, thematic mapping, co-citation analysis, and international collaboration network analysis were performed to explore the conceptual, intellectual, and social structures of the literature. Results: The 3,602 articles were published across 188 journals and authored by 14,984 researchers, with an average of 5.42 citations per document and an international co-authorship rate of 17.3%. The most productive journals were BMC Nursing, Journal of Advanced Nursing, and Journal of Clinical Nursing. Keyword co-occurrence analysis showed that "symptoms," "depression," "anxiety," "nursing," and "quality of life" were the most frequent terms, indicating a strong focus on multidimensional symptom burden and psychological distress. Thematic mapping identified "symptoms," "depression," and "anxiety" as motor themes, while nursing care and palliative care emerged as basic themes with high relevance but lower development. Emerging or underrepresented themes included pediatric and family-centered perspectives. Co-citation analysis revealed that the intellectual foundation of the field is shaped by symptom science, mental health assessment, and behavioral theory. The United States, China, and Australia were the most collaborative countries, while several regions showed growing but limited international collaboration. Conclusion: Nursing research on symptom management in heart failure is predominantly centered on psychological symptoms and overall symptom burden. Although this core area is well developed, gaps remain in nursing-led interventions, guideline implementation, and family- and life-course–oriented approaches. Strengthening international collaboration and expanding research into underdeveloped themes may advance evidence-based symptom management in heart failure nursing.