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Dying from heart disease

M McCarthy1, M Lay, J Addington-Hall

  • 1Department of Epidemiology and Public Health, University College, London.

Journal of the Royal College of Physicians of London
|July 1, 1996
PubMed
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Patients with heart disease experience distressing symptoms like pain and dyspnea in their last year of life. Palliative care in hospitals needs improvement for better symptom management and quality of life.

Area of Science:

  • Cardiology
  • Palliative Care
  • Patient Experience

Background:

  • Heart disease is a leading cause of mortality.
  • Symptom burden in the final year of life significantly impacts quality of life.
  • Understanding patient and carer experiences is crucial for improving end-of-life care.

Purpose of the Study:

  • To detail symptoms experienced by heart disease patients in their last year of life.
  • To examine the relationship between these symptoms and quality of life.
  • To assess informal carers' satisfaction with hospital services.

Main Methods:

  • A survey of informal carers for 600 deceased heart disease patients (aged 15+).
  • Interviews conducted approximately 10 months post-mortem.
  • Study involved 20 English health districts, nationally representative in social and health service characteristics.

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Main Results:

  • Over 50% of patients experienced pain, dyspnea, and low mood.
  • Other distressing symptoms included anxiety, constipation, nausea, and incontinence.
  • Hospital symptom control was inadequate for a significant percentage of patients (e.g., 35% for pain).
  • Despite symptom control issues, carer satisfaction with hospital staff was high.

Conclusions:

  • Heart disease patients face a broad spectrum of distressing, long-lasting symptoms.
  • There is a clear need to enhance hospital-based palliative care for cardiac patients.
  • Improving symptom management is key to enhancing end-of-life care for heart disease patients.