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Drifting in a shrinking future: living with advanced heart failure
Cynthia M Dougherty1, Gail P Pyper, David H Au
1Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, Seattle, WA 98195, USA. cindyd@u.washington.edu
The Journal of Cardiovascular Nursing
|December 20, 2007
Summary
Patients with advanced heart failure (HF) struggle with future planning and end-of-life care discussions. Improved provider communication is crucial for better advance care planning in HF patients.
Area of Science:
- Cardiology
- Palliative Care
- Qualitative Research
Background:
- Advanced heart failure (HF) patients face uncertain prognoses.
- Low rates of advance care planning and hospice utilization are common in HF.
- Understanding patient perspectives on future planning is essential.
Purpose of the Study:
- To explore how patients with advanced heart failure (HF) perceive and plan for their future.
- To identify barriers to advance care planning discussions in HF.
Main Methods:
- Conducted semistructured interviews with 24 patients experiencing heart disease.
- Utilized constant comparative method for grounded theory analysis of interview transcripts.
Main Results:
- Patients desired discussions about HF's impact on their future with healthcare providers.
- Difficulty initiating these conversations led to patient frustration.
- Life expectancy estimates were not perceived as helpful for coping or planning.
Conclusions:
- Patients with advanced HF often fail to adequately plan for end-of-life care.
- A tendency to passively hope for the best was observed.
- End-of-life care strategies must address communication challenges and decision-making difficulties between patients and providers.
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