Comorbidity in modern nursing: a closer look at heart failure

Comorbidity, which is the experience of other disorders or diseases in addition to an index condition, is common in older patients and is set to increase as the population ages. Comorbidity impacts on both clinical management and patient self-care, resulting in poorer patient outcomes in terms of mortality and morbidity. This article explores these issues in the context of heart failure, a condition that falls disproportionately on older people and where comorbidity is the norm rather than the exception. In heart failure comorbidity impacts on the diagnosis and management of patients and adversely impacts on their self-care activities, including symptom recognition, lifestyle modifications, drug adherence and contact with health professionals. Over the past decade health care has become preoccupied with national, standardized guidelines and single disease pathologies. Nursing as a profession has developed along this trajectory with increasingly disease-targeted specialist roles. It is time for health care to broaden its focus onto the patient as a whole, and for nursing to reestablish its professional roots in a holistic approach.