scholarly journals What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephanie M. C. Ament ◽  
Lisette M. van den Broek ◽  
Marieke H. J. van den Beuken-van Everdingen ◽  
Josiane J. J. Boyne ◽  
José M. C. Maessen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Qualitative Study ◽  
Needs Assessment ◽  
Healthcare Professionals ◽  
Assessment Tool ◽  
Assessment Tools ◽  
Care Needs ◽  
Palliative Care Needs

Abstract Background Needs assessment tools can facilitate healthcare professionals in timely recognition of palliative care needs. Despite the increased attention for implementation of such tools, most studies provide little or no attention to the context of implementation. The aim of this study was to explore factors that contribute positively and negatively to timely screening of palliative care needs in advanced chronic heart failure. Methods Qualitative study using individual interviews and focus groups with healthcare professionals. The data were analysed using a deductive approach. The Consolidated Framework for Implementation Research was used to conceptualise the contextual factors. Results Twenty nine healthcare professionals with different backgrounds and working in heart failure care in the Southern and Eastern parts of the Netherlands participated. Several factors were perceived to play a role, such as perception and knowledge about palliative care, awareness of palliative care needs in advanced chronic heart failure, perceived difficulty when and how to start palliative care, limited acceptance to treatment boundaries in cardiology, limited communication and collaboration between healthcare professionals, and need for education and increased attention for palliative care in advanced chronic heart failure guidelines. Conclusions This study clarified critical factors targeting patients, healthcare professionals, organisations to implement a needs assessment tool for timely recognition of palliative care needs in the context of advanced chronic heart failure. A multifaceted implementation strategy is needed which has attention for education, patient empowerment, interdisciplinary collaboration, identification of local champions, chronic heart failure specific guidelines and culture.

Timely recognition of palliative care needs of patients with advanced chronic heart failure: a pilot study of a Dutch translation of the Needs Assessment Tool: Progressive Disease – Heart Failure (NAT:PD-HF)

2019 ◽  
Vol 18 (5) ◽  
pp. 375-388 ◽  
Author(s):  
Daisy JA Janssen ◽  
Josiane Boyne ◽  
David C Currow ◽  
Jos MGA Schols ◽  
Miriam J Johnson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Health Status ◽  
Chronic Heart Failure ◽  
Needs Assessment ◽  
Caregiver Burden ◽  
Assessment Tool ◽  
Care Needs ◽  
Care Dependency ◽  
Palliative Care Needs

Background: The Needs Assessment Tool: Progressive Disease – Heart Failure (NAT:PD-HF) was developed to identify and triage palliative care needs in patients with chronic heart failure. A Dutch version is currently lacking. Aims: The aim of this study was to investigate the feasibility and acceptability of a Dutch NAT:PD-HF in chronic heart failure outpatients; and to gain preliminary data regarding the effect of the NAT:PD-HF on palliative care referral, symptoms, health status, care dependency, caregiver burden and advance directives. Methods: A mixed methods study including 23 outpatients with advanced chronic heart failure and 20 family caregivers was performed. Nurses conducted patient consultations using a Dutch translation of the NAT:PD-HF and rated acceptability. Before this visit and 4 months later, symptoms, health status, performance status, care dependency, caregiver burden and recorded advance directives were assessed. A focus group with participating nurses discussed barriers and facilitators towards palliative care needs assessment. Results: Acceptability was rated as 7 (interquartile range 6–7 points) on a 10-point scale. All patients had palliative care needs. In 48% actions were taken, including two patients referred to palliative care. Symptoms, performance status, care dependency, caregiver burden and advance directives were unchanged at 4 months, while health status deteriorated in patients completing follow-up ( n=17). Barriers towards palliative care needs assessment included feeling uncomfortable to initiate discussions and concerns about the ability to address palliative care needs. Conclusions: The NAT:PD-HF identified palliative care needs in all participants, and triggered action to address these in half. However, training in palliative care communication skills as well as palliative care interventions should accompany the introduction of a palliative care needs assessment tool. Netherlands National Trial Register (NTR): 5616. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5616

scholarly journals Tools to help healthcare professionals recognize palliative care needs in patients with advanced heart failure: A systematic review

2020 ◽  
pp. 026921632096394 ◽  
Author(s):  
Stephanie MC Ament ◽  
Inge ME Couwenberg ◽  
Josiane JJ Boyne ◽  
Jos Kleijnen ◽  
Henri EJH Stoffers ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Care Process ◽  
Care Needs ◽  
Process Guidance ◽  
Palliative Care Needs

Background: The delivery of palliative care interventions is not widely integrated in chronic heart failure care as the recognition of palliative care needs is perceived as difficult. Tools may facilitate healthcare professionals to identify patients with palliative care needs in advanced chronic heart failure. Aim: To identify tools to help healthcare professionals recognize palliative care needs in patients with advanced chronic heart failure. Design: This systematic review was registered in the PROSPERO database (CRD42019131896). Evidence of tools’ development, evaluation, feasibility, and implementation was sought and described. Data sources: Electronic searches to identify references of tools published until June 2019 were conducted in MEDLINE, CINAHL, and EMBASE. Hand-searching of references and citations was undertaken. Based on the identified tools, a second electronic search until September 2019 was performed to check whether all evidence about these tools in the context of chronic heart failure was included. Results: Nineteen studies described a total of seven tools. The tools varied in purpose, intended user and properties. The tools have been validated to a limited extent in the context of chronic heart failure and palliative care. Different health care professionals applied the tools in various settings at different moments of the care process. Guidance and instruction about how to apply the tool revealed to be relevant but may be not enough for uptake. Spiritual care needs were perceived as difficult to assess. Conclusion: Seven tools were identified which showed different and limited levels of validity in the context of palliative care and chronic heart failure.

scholarly journals Palliative care needs-assessment and measurement tools used in patients with heart failure: a systematic mixed-studies review with narrative synthesis

2020 ◽  
Vol 26 (1) ◽  
pp. 137-155
Author(s):  
Bader Nael Remawi ◽  
Amy Gadoud ◽  
Iain Malcolm James Murphy ◽  
Nancy Preston
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Needs Assessment ◽  
Assessment Tool ◽  
Cochrane Library ◽  
Patient Needs ◽  
Care Needs ◽  
Patients With Heart Failure ◽  
Measurement Tools ◽  
Palliative Care Needs

AbstractPatients with heart failure have comparable illness burden and palliative care needs to those with cancer. However, few of them are offered timely palliative care. One main barrier is the difficulty in identifying those who require palliative care. Several palliative care needs-assessment/measurement tools were used to help identify these patients and assess/measure their needs, but it is not known which one is the most appropriate for this population. This review aimed to identify the most appropriate palliative care needs-assessment/measurement tools for patients with heart failure. Cochrane Library, MEDLINE Complete, AMED, PsycINFO, CINAHL Complete, EMBASE, EThOS, websites of the identified tools, and references and citations of the included studies were searched from inception to 25 June 2020. Studies were included if they evaluated palliative care needs-assessment/measurement tools for heart failure populations in terms of development, psychometrics, or palliative care patient/needs identification. Twenty-seven papers were included regarding nineteen studies, most of which were quantitative and observational. Six tools were identified and compared according to their content and context of use, development, psychometrics, and clinical applications in identifying patients with palliative care needs. Despite limited evidence, the Needs Assessment Tool: Progressive Disease – Heart Failure (NAT:PD-HF) is the most appropriate palliative care needs-assessment tool for use in heart failure populations. It covers most of the patient needs and has the best psychometric properties and evidence of identification ability and appropriateness. Psychometric testing of the tools in patients with heart failure and evaluating the tools to identify those with palliative care needs require more investigation.

scholarly journals Characteristics for a tool for timely identification of palliative needs in heart failure: The views of Dutch patients, their families and healthcare professionals

2020 ◽  
pp. 147451512091896 ◽  
Author(s):  
Daisy JA Janssen ◽  
Stephanie MC Ament ◽  
Josiane Boyne ◽  
Jos MGA Schols ◽  
Hans-Peter Brunner-La Rocca ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Healthcare Professionals ◽  
Family Members ◽  
Relative Advantage ◽  
Successful Implementation ◽  
Care Needs ◽  
Design Quality ◽  
Palliative Care Needs

Background Palliative care can improve outcomes for patients with advanced chronic heart failure and their families, but timely recognition of palliative care needs remains challenging. Aim The aim of this study was to identify characteristics of a tool to assess palliative care needs in chronic heart failure that are needed for successful implementation, according to patients, their family and healthcare professionals in The Netherlands. Methods Explorative qualitative study, part of the project ‘Identification of patients with HeARt failure with PC needs’ (I-HARP), focus groups and individual interviews were held with healthcare professionals, patients with chronic heart failure, and family members. Data were analysed using the Consolidated Framework for Implementation Research. Results A total of 13 patients, 10 family members and 26 healthcare professionals participated. Direct-content analysis revealed desired tool characteristics for successful implementation in four constructs: relative advantage, adaptability, complexity, and design quality and packaging. Healthcare professionals indicated that a tool should increase awareness, understanding and knowledge concerning palliative care needs. A tool needs to: be adaptable to different disease stages, facilitate early identification of palliative care needs and ease open conversations about palliative care. The complexity of chronic heart failure should be considered in a personalized approach. Conclusions The current study revealed the characteristics of a tool for timely identification of palliative care needs in chronic heart failure needed for successful implementation. The next steps will be to define the content of the tool, followed by development of a preliminary version and iterative testing of this version by the different stakeholders.

Palliative care needs assessment in chronic heart failure

2018 ◽  
Vol 12 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Daisy J.A. Janssen ◽  
Miriam J. Johnson ◽  
Martijn A. Spruit
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Needs Assessment ◽  
Care Needs ◽  
Palliative Care Needs

Palliative Care Needs Assessment Tool

2008 ◽  
Author(s):  
A. Waller ◽  
A. Girgis ◽  
D. Currow ◽  
C. Lecathelinais
Keyword(s):  
Palliative Care ◽  
Needs Assessment ◽  
Assessment Tool ◽  
Care Needs ◽  
Palliative Care Needs

The integrated palliative care outcome scale for patients with palliative care needs: Factors related to and experiences of the use in acute care settings

2019 ◽  
Vol 17 (5) ◽  
pp. 561-568 ◽  
Author(s):  
Susanne Lind ◽  
Lars Wallin ◽  
Carl Johan Fürst ◽  
Ingela Beck
Keyword(s):  
Palliative Care ◽  
Acute Care ◽  
Healthcare Professionals ◽  
Assessment Tools ◽  
Successful Implementation ◽  
Care Needs ◽  
Palliative Care Outcome Scale ◽  
Acute Care Settings ◽  
Palliative Care Needs ◽  
Care Outcome

AbstractObjectiveImplementation of patient-reported outcome measures for patients with palliative care needs is characterized by both enablers and barriers. The ways in which healthcare professionals experience the use of assessment tools is important. Our aims were to explore factors contributing to or hindering patients with palliative care needs in assessing their symptoms with the Integrated Palliative Care Outcome Scale (IPOS) and to explore healthcare professionals’ experiences of the use of IPOS in acute care settings.MethodData were collected as a part of the evaluation of the feasibility of an implementation strategy for introducing IPOS. Data from three participating acute care units were included. We used descriptive and analytical statistics; a qualitative content analysis was also performed.ResultA total of 309 patients were eligible to be offered assessment of symptoms with IPOS. Of these 69 (22%) had completed IPOS. A significant positive association was found between healthcare professionals’ participation in training sessions and completed IPOS. The experiences of IPOS were split into two categories: “IPOS acting as a facilitator” and “barriers to the use of IPOS.” The use of IPOS was described as contributing to person-centered care of patients with palliative care needs and inspiration to improved routines. Healthcare professionals’ feelings of uncertainty about how to approach severely ill patients and their family members appear to have hindered their use of IPOS.Significance of resultsWe found an association between healthcare professionals’ participation in training sessions and patients who completed IPOS, indicating the need for a high degree of attendance at the training to achieve successful implementation. The healthcare professionals expressed feelings of insecurity concerning the use of IPOS indicating a need for further education and clinical support in its use of IPOS. Nevertheless, use of IPOS was considered to contribute to improved care of patients with palliative care needs.

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