scholarly journals Current Trends and Possibilities of Providing Medical Palliative Care in Chronic Heart Failure

Kardiologiia ◽  
2019 ◽  
Vol 59 (1) ◽  
pp. 84-92
Author(s):  
V. N. Larina ◽  
I. I. Chukaeva ◽  
V. G. Larin
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Terminal Phase ◽  
Treatment Resistant ◽  
Current Trends ◽  
Appropriate Care ◽  
High Prevalence ◽  
Oncological Diseases ◽  
Specialized Palliative Care

Chronic heart failure (CHF) is an important healthcare problem because of high prevalence, morbidity and mortality rates. Treatment resistant symptoms, need for communication and support, unite patients with CHF and oncological diseases but despite that CHF patients rarely receive specialized palliative care (SPC). This review is devoted to the need and possible ways of providing SPC to patients with CHF and their families. We discuss here variants of CHF course in terminal phase, the term end of life appropriate care, various specialists’ concepts of SPC delivering to CHF patients in accordance with their preferences.

scholarly journals Understanding how a palliative-specific patient-reported outcome intervention works to facilitate patient-centred care in advanced heart failure: A qualitative study

2017 ◽  
Vol 32 (1) ◽  
pp. 143-155 ◽  
Author(s):  
Pauline M Kane ◽  
Clare I Ellis-Smith ◽  
Barbara A Daveson ◽  
Karen Ryan ◽  
Niall G Mahon ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Unmet Needs ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Specific Patient ◽  
Patient Centred Care ◽  
Palliative Care Outcome Scale ◽  
Patient Reported

Background: Palliative care needs of patients with chronic heart failure are poorly recognised. Policy makers advise a patient-centred approach to holistically assess patients’ needs and care goals. Patient-reported outcome measures are proposed to facilitate patient-centred care. Aim: To explore whether and how a palliative care–specific patient-reported outcome intervention involving the Integrated Palliative care Outcome Scale influences patients’ experience of patient-centred care in nurse-led chronic heart failure disease management clinics. Design: A feasibility study using a parallel mixed-methods embedded design was undertaken. The qualitative component which examined patients and nurses experience of the intervention is reported here. Semi-structured interviews were conducted and analysed using framework analysis. Setting/participants: Eligible patients attended nurse-led chronic heart failure disease management clinics in two tertiary referral centres in Ireland with New York Heart Association functional class II–IV. Nurses who led these clinics were eligible for inclusion. Results: In all, 18 patients and all 4 nurses involved in the nurse-led clinics were interviewed. Three key themes were identified: identification of unmet needs, holistic assessment and patient empowerment. The intervention impacted on processes of care by enabling a shared understanding of patients’ symptoms and concerns, facilitating patient–nurse communication by focusing on these unmet needs and empowering patients to become more involved in clinical discussions. Conclusion: This Integrated Palliative care Outcome Scale–based intervention empowered patients to become more engaged in the clinical consultation and to highlight their unmet needs. This study adds to the evidence for the mechanism of action of patient-reported outcome measures to improve patient-centred care and will help inform outcome selection for future patient-reported outcome measure research.

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 Giving Voice to Patients' and Family Caregivers' Needs in Chronic Heart Failure: Implications for Palliative Care Programs

2011 ◽  
Vol 14 (12) ◽  
pp. 1317-1324 ◽  
Author(s):  
David B. Bekelman ◽  
Carolyn T. Nowels ◽  
Jessica H. Retrum ◽  
Larry A. Allen ◽  
Simon Shakar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Family Caregivers

Outpatient Palliative Care for Chronic Heart Failure: A Case Series

2011 ◽  
Vol 14 (7) ◽  
pp. 815-821 ◽  
Author(s):  
David B. Bekelman ◽  
Carolyn T. Nowels ◽  
Larry A. Allen ◽  
Simon Shakar ◽  
Jean S. Kutner ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Case Series

Sincere Effort for Palliative Care in Chronic Heart Failure∼Challenges at a Cardiovascular Center∼

2012 ◽  
Vol 18 (10) ◽  
pp. S166
Author(s):  
Shogo Oishi ◽  
Gaku Kanda ◽  
Ayumu Takehara ◽  
Naoko Tanaka ◽  
Kazuyo Kurita ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Chronic Heart Failure ◽  
Cardiovascular Center ◽  
Sincere Effort

The Prevalence of depression in outpatients attending a chronic heart failure with reduced ejection fraction clinic in a tertiary academic centre in Johannesburg, South Africa

2020 ◽  
Author(s):  
Nqoba Tsabedze ◽  
Jamie-Leigh Kinsey ◽  
Dineo Mpanya ◽  
Vanessa Mogashoa ◽  
Eric Klug ◽  
...  
Keyword(s):  
Mental Health ◽  
Heart Failure ◽  
Chronic Heart Failure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Heart Failure Clinic ◽  
High Prevalence ◽  
Prevalence Of Depression ◽  
The Impact ◽  
Predictors Of Depression

Abstract Background: In high income countries depression is reported to affect at least one-fifth of patients with chronic heart failure (CHF). Mental health problems have been associated with frequent rehospitalisation and an increased risk of all-cause mortality. Despite the reported high prevalence of depression in CHF, there is a paucity of data on this subject from the developing world. The aim of the study was to determine the prevalence of depression, stress and anxiety in patients attending a dedicated chronic heart failure clinic. Methods: A prospective study was conducted at an outpatient heart failure clinic, in a tertiary academic centre over a nine month period in 2016. The study participants completed a Depression, Anxiety and Stress (DASS-21) questionnaire to screen for the presence and severity of depression, anxiety and stress. Descriptive statistics and logistic regression analysis was used to identify predictors of depression.Results: The study population comprised of 103 patients, predominantly female (62.1%) with a median age of 53 (interquartile range 38 – 61). Hypertension was the most common co-morbidity, reported in 35.9% of patients. Depression was reported by 54 (52.4%) with 12(11.7%) reporting extremely severe depression. Anxiety was diagnosed in 55 (53.4%) patients with extremely severe anxiety reported by 19 (18.4%) patients. Fifty patients (48.5%) were classified as stressed and only 8 (7.7%) had extremely severe stress. More than half of the patients (54.4%) were in New York Heart Association (NYHA) functional class I with a mean (SD) left ventricular ejection (LVEF) of 30.5 (11.1) %. The six-minute walk test (odds ratio (OR) -0.07, 95% confidence interval (CI) -0.01 – 0.00, p=0.012) and the Minnesota Living with Heart Failure score (OR 0.04, CI 0.02 – 0.01, p=0.001) were identified as independent predictors of depression. Conclusion: The prevalence of depression and anxiety was found in over half of our patients attending the chronic heart failure clinic. In view of the high prevalence of psychosocial stressors in CHF, we recommend that mental health screening should be considered. Prospective, adequately powered, multicentre studies from developing countries investigating the impact of depression on heart failure hospitalisation and mortality are still required.

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