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Communicating prognosis and end-of-life care to heart failure patients: a survey of heart failure nurses' perspectives
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-4259-3671
Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.ORCID iD: 0000-0002-9606-3238
Hälsohögskolan, Jönköping, Sweden.
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2014 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, no 2, 152-161 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Many heart failure (HF) patients have palliative care needs, but communication about prognosis and end-of-life care is lacking. HF nurses can play an important role in such communication, but their views on this have rarely been sought.

AIMS:

This study aims to describe HF nurses' perspectives on, and daily practice regarding, discussing prognosis and end-of-life care with HF patients in outpatient care. It further aims to explore barriers, facilitators and related factors for discussing these issues.

METHODS:

A national survey including nurses from outpatient clinics and primary health care centres was performed. Data was collected using a questionnaire on communication with HF patients about prognosis and end-of-life care.

RESULTS:

In total, 111 (82%) of the HF nurses completed the questionnaire. Most of them reported that physicians should have the main responsibility for discussing prognosis (69%) and end-of-life care (67%). Most nurses felt knowledgeable to have these discussions, but 91% reported a need for further training in at least one of the areas. Barriers for communication about prognosis and end-of-life care included the unpredictable trajectory of HF, patients' comorbidities and the opinion that patients in NYHA class II-III are not in the end-of-life.

CONCLUSION:

Although HF nurses feel competent discussing prognosis and end-of-life care with the HF patient, they are hesitant to have these conversations. This might be partly explained by the fact that they consider the physician to be responsible for such conversations, and by perceived barriers to communication. This implies a need for clinical policy and education for HF nurses to expand their knowledge and awareness of the patients' possible needs for palliative care.

Place, publisher, year, edition, pages
Sage Publications, 2014. Vol. 13, no 2, 152-161 p.
Keyword [en]
Heart failure, communication, end-of-life care, nurse attitudes, palliative care, prognosis
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-106263DOI: 10.1177/1474515114521746PubMedID: 24480779Scopus ID: 2-s2.0-84896797220OAI: oai:DiVA.org:liu-106263DiVA: diva2:715223
Available from: 2014-05-02 Created: 2014-05-02 Last updated: 2017-12-05Bibliographically approved

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Hjelmfors, LisaStrömberg, AnnaFriedrichsen, MariaJaarsma, Tiny

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European Journal of Cardiovascular Nursing
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CiteExportLink to record
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