Lisa Hjelmfors1, Martje H L van der Wal1,2, Maria J Friedrichsen1, Jan Mårtensson3, Anna Strömberg4, Tiny Jaarsma1. 1. 1 Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University , Linköping, Sweden . 2. 2 Department of Cardiology, University of Groningen, University Medical Center Groningen , Groningen, the Netherlands . 3. 3 Department of Nursing, School of Health Sciences, Jönköping University , Jönköping, Sweden . 4. 4 Department of Medical and Health Sciences, Division of Nursing, Faculty of Health Sciences and Department of Cardiology, Linköping University , Linköping, Sweden .
Abstract
BACKGROUND: Although several studies advise that discussions about prognosis and end-of-life care should be held throughout the whole heart failure (HF) trajectory, data is lacking on the prevalence and practice of such discussions in HF care. OBJECTIVE: The study objective was to explore how often and why HF nurses in outpatient clinics discuss prognosis and end-of-life care in the context of patient education. METHODS: This was a descriptive and comparative study. Participants were HF nurses from Swedish and Dutch HF outpatient clinics. Measurements were taken via a survey for both quantitative and qualitative data. Additional data was collected via open-ended questions and analyzed with content analysis. RESULTS: Two hundred seventy-nine nurses registered 1809 patient conversations using a checklist. Prognosis and end-of-life care were among the least frequently discussed topics, whereas symptoms of HF was discussed most often. Prognosis was discussed with 687 patients (38%), and end-of-life care was discussed with 179 patients (10%). Prognosis and end-of-life care were discussed more frequently in The Netherlands than in Sweden (41% versus 34%, p<0.001, 13% versus 4%, p<0.001). The nurses did not always recognize prognosis and end-of-life care discussions as a part of their professional role. CONCLUSIONS: Currently, patient-nurse communication about prognosis and end-of-life care does not seem to be routine in patient education in HF clinics, and these discussions could be included more often. The reasons for nurses to discuss these topics were related to clinical routines, the patient's situation, and professional responsibilities. To improve future care, communication with patients needs to be further developed.
BACKGROUND: Although several studies advise that discussions about prognosis and end-of-life care should be held throughout the whole heart failure (HF) trajectory, data is lacking on the prevalence and practice of such discussions in HF care. OBJECTIVE: The study objective was to explore how often and why HF nurses in outpatient clinics discuss prognosis and end-of-life care in the context of patient education. METHODS: This was a descriptive and comparative study. Participants were HF nurses from Swedish and Dutch HF outpatient clinics. Measurements were taken via a survey for both quantitative and qualitative data. Additional data was collected via open-ended questions and analyzed with content analysis. RESULTS: Two hundred seventy-nine nurses registered 1809 patient conversations using a checklist. Prognosis and end-of-life care were among the least frequently discussed topics, whereas symptoms of HF was discussed most often. Prognosis was discussed with 687 patients (38%), and end-of-life care was discussed with 179 patients (10%). Prognosis and end-of-life care were discussed more frequently in The Netherlands than in Sweden (41% versus 34%, p<0.001, 13% versus 4%, p<0.001). The nurses did not always recognize prognosis and end-of-life care discussions as a part of their professional role. CONCLUSIONS: Currently, patient-nurse communication about prognosis and end-of-life care does not seem to be routine in patient education in HF clinics, and these discussions could be included more often. The reasons for nurses to discuss these topics were related to clinical routines, the patient's situation, and professional responsibilities. To improve future care, communication with patients needs to be further developed.
Authors: Soraya Matthews; Mark Ward; Anne Nolan; Charles Normand; Rose Anne Kenny; Peter May Journal: BMC Geriatr Date: 2022-06-21 Impact factor: 4.070
Authors: Lisa Hjelmfors; Jan Mårtensson; Anna Strömberg; Anna Sandgren; Maria Friedrichsen; Tiny Jaarsma Journal: Int J Environ Res Public Health Date: 2022-04-15 Impact factor: 4.614
Authors: Lisa Hjelmfors; Anna Strömberg; Maria Friedrichsen; Anna Sandgren; Jan Mårtensson; Tiny Jaarsma Journal: BMC Palliat Care Date: 2018-06-11 Impact factor: 3.234
Authors: Casey E Cavanagh; Lindsey Rosman; Erica S Spatz; Terri Fried; Parul U Gandhi; Richard J Soucier; Matthew M Burg Journal: ESC Heart Fail Date: 2020-09-24