4.5 Article

Perceptions of Need for Palliative Care in Recently Hospitalized Patients With Systolic Heart Failure

期刊

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
卷 62, 期 6, 页码 1252-1261

出版社

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jpainsymman.2021.06.001

关键词

Palliative care; heart failure; symptom management; health services research; depression

资金

  1. National Heart, Lung and Blood Institute [R01 HL114016]
  2. NHLBI [K01HL133466]
  3. Cystic Fibrosis Foundation [KAVAL19QI0]

向作者/读者索取更多资源

The study suggests that factors such as depression, non-white race, more severe HF symptoms, and lower quality of life are associated with the perceived need for palliative care in HF patients.
Context. The symptom burden associated with heart failure (HF) remains high despite improvements in therapy and calls for the integration of palliative care into traditional HF care. Little is also known about how patients with HF perceive palliative care and patient-level characteristics associated with the need for palliative care, which could influence the utilization of palliative care in HF management. Objectives. To identify characteristics of HF patients associated with perceived need for palliative care. Methods. We analyzed data from the Hopeful Heart Trial, which studied the efficacy of a collaborative care intervention for treating both systolic HF and depression. Palliative care preferences were collected during routine study follow-up. We assessed the association of perceived need for palliative care during study follow-up and baseline data on sociodemographics, clinical measures, and patient-centered outcomes. We then used descriptive statistics and logistic regression to analyze our data. Results. Participants were on average 64 years old, male, and reported severe HF symptoms and poor to below average quality of life (. Most had unfavorable impressions of palliative care, but many still perceived a need for palliative care. Factors associated with perceived need for palliative care included depression, non-white race, more severe HF symptoms, and lower mental & physical health-related quality of life. Conclusion. HF patients' beliefs about palliative care may affect utilization of palliative care. Specific characteristics can help identify patients with HF who may benefit from palliative care involvement. Education targeted towards patients with selected attributes may help incorporate palliative care into HF management. (C) 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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