Abstract

Purpose: Thirst, characterized by sensations of oral dryness and a craving to drink, is a ubiquitous experience among heart failure (HF) patients. Besides reduced cardiac output, the clinical treatments for HF patients (e.g., diuretics, fluid restriction) may activate the renin-angiotensin-aldosterone system (RAAS), exacerbating their thirst distress.

Negative emotions are commonly experienced among heart failure patients. Previous studies have suggested that emotions (e.g., anxiety, depression) may activate the sympathetic nervous system, reducing the secretion of saliva, which, in turn, may increase sensations of dry mouth among HF patients. However, the relationship between emotions and thirst distress remains unclear. Therefore, the aim of this study was to examine the association between emotions and thirst distress among HF patients.

Methods: A 5-day longitudinal study employing ecological momentary assessment (EMA) was conducted. We recruited a convenience sample of HF patients from a medical center in Taipei, Taiwan. Participants reported their emotional states and thirst distress four times daily using the International Positive and Negative Affect Schedule Short Form and the Thirst Distress Scale for patients with HF. For our specific aim, we employed linear mixed model for data analysis.

Results: A total of 50 participants (mean age 63.5±16 years; 66% male; 70% NYHA class II-III) completed 537 valid EMA observations on 165 person-days. The median score for thirst distress was 16.0 (IQR = 10.0, 22.0). After adjusting for potential confounders, we observed that positive emotions (β= 0.1, 95% CI = < 0.1, 0.2) and negative emotions (β= 0.5, 95% CI = 0.2, 0.8) were positively associated with increased levels of thirst distress among HF patients.

Conclusion: Our findings suggest that both positive and negative emotions may increase thirst distress among HF patients. Strategies such as breathing training, mindfulness, or biofeedback may help HF patients to stabilize their emotions, which may further mitigate their thirst distress and improve their quality of life.

Notes

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References:

Chen, Y., Ding, J., Xi, Y., Huo, M., Mou, Y., Song, Y., Zhou, H., & Cui, X. (2023). Thirst in heart failure: A scoping review. Nursing open, 10(8), 4948–4958. https://doi.org/10.1002/nop2.1818

Calderone, A., Marafioti, G., Latella, D., Corallo, F., D'Aleo, P., Quartarone, A., & Calabrò, R. S. (2025). Effectiveness of relaxation techniques for stress management and quality of life improvement in cardiovascular disease and hypertensive patients: a systematic review. Psychology, health & medicine, 30(7), 1281–1352. https://doi.org/10.1080/13548506.2025.2458255

Eng, S. H., 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. (2021). Thirst distress in outpatients with heart failure in a Mediterranean zone of Spain. ESC heart failure, 8(4), 2492–2501. https://doi.org/10.1002/ehf2.13395

Younes, K., Massouh, A., Deek, H., Nasreddine, L., Waldréus, N., & Noureddine, S. (2025). Prevalence and predictors of thirst in patients with heart failure. The Journal of cardiovascular nursing, 40(5), 431–440. https://doi.org/10.1097/JCN.0000000000001175

Zheng, Y., Chen, Q., Xia, C., & Liu, H. (2025). Thirst symptoms in patients with heart failure: An integrative review. Journal of advanced nursing, 81(1), 35–52. https://doi.org/10.1111/jan.16250

Description

This study suggests that both positive and negative emotions may exacerbate thirst distress levels among patients with heart failure. Consequently, emotional stability appears to be a relevant factor in thirst management. Strategies such as breathing training, mindfulness, or biofeedback could be considered as potential approaches to support emotional regulation and alleviate thirst distress.

Author Details

Chieh-An Yang, Masters Degree, RN; Hsing-Mei Chen, PhD; Tsung-Neng Tsai, PhD; Chieh-Yu Liu,  PhD; Hui-Ju Lu, RN; Ting-Ti Lin, PhD

Sigma Membership

Lambda Beta at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Longitudinal Study

Research Approach

Other

Keywords:

Acute Care, Hospice, Palliative, End-of-Life, Heart Failure, Heart Failure Patients, Thirst, Emotions

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-08-27

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The Impacts of Emotions on Thirst Among Heart Failure Patients

Toronto, Ontario, Canada

Purpose: Thirst, characterized by sensations of oral dryness and a craving to drink, is a ubiquitous experience among heart failure (HF) patients. Besides reduced cardiac output, the clinical treatments for HF patients (e.g., diuretics, fluid restriction) may activate the renin-angiotensin-aldosterone system (RAAS), exacerbating their thirst distress.

Negative emotions are commonly experienced among heart failure patients. Previous studies have suggested that emotions (e.g., anxiety, depression) may activate the sympathetic nervous system, reducing the secretion of saliva, which, in turn, may increase sensations of dry mouth among HF patients. However, the relationship between emotions and thirst distress remains unclear. Therefore, the aim of this study was to examine the association between emotions and thirst distress among HF patients.

Methods: A 5-day longitudinal study employing ecological momentary assessment (EMA) was conducted. We recruited a convenience sample of HF patients from a medical center in Taipei, Taiwan. Participants reported their emotional states and thirst distress four times daily using the International Positive and Negative Affect Schedule Short Form and the Thirst Distress Scale for patients with HF. For our specific aim, we employed linear mixed model for data analysis.

Results: A total of 50 participants (mean age 63.5±16 years; 66% male; 70% NYHA class II-III) completed 537 valid EMA observations on 165 person-days. The median score for thirst distress was 16.0 (IQR = 10.0, 22.0). After adjusting for potential confounders, we observed that positive emotions (β= 0.1, 95% CI = < 0.1, 0.2) and negative emotions (β= 0.5, 95% CI = 0.2, 0.8) were positively associated with increased levels of thirst distress among HF patients.

Conclusion: Our findings suggest that both positive and negative emotions may increase thirst distress among HF patients. Strategies such as breathing training, mindfulness, or biofeedback may help HF patients to stabilize their emotions, which may further mitigate their thirst distress and improve their quality of life.