Professionals guidance about palliative medicine in chronic heart failure: a mixed-method study

Ament, Stephanie M C; Beuken-Everdingen, Marieke van den; Maessen, J.; Boyne, Josiane; Schols, Jos M. G. A.; Stoffers, Jelle; Bellersen, Louise; Rocca, Hans‐Peter Brunner‐La; Engels, Yvonne; Janssen, Daisy J.A.

doi:10.1136/bmjspcare-2020-002580

Cited by 6 publications

(13 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 32 For patients with heart failure, the I-HARP has recently been developed. 33 Finamore et al attempted to cluster patients with COPD by their symptoms, which could be a first step to development of such a tool specific for COPD. 34 However, due to limited time and financial resources, it is not attainable to provide a comprehensive person-centered assessment to all patients with COPD.…”

Section: Discussionmentioning

confidence: 99%

External Validation and User Experiences of the ProPal-COPD Tool to Identify the Palliative Phase in COPD

Broese

Kleij

Verschuur

et al. 2022

COPD

Self Cite

View full text Add to dashboard Cite

Background: Difficulty predicting prognosis is a major barrier to timely palliative care provision for patients with COPD. The ProPal-COPD tool, combining six clinical indicators and the Surprise Question (SQ), aims to predict 1-year mortality as a proxy for palliative care needs. It appeared to be a promising tool for healthcare providers to identify patients with COPD who could benefit from palliative care. Objective: To externally validate the ProPal-COPD tool and to assess user experiences. Methods: Patients admitted with an acute exacerbation COPD were recruited across 10 hospitals. Demographics, clinical characteristics and survival status were collected. Sensitivity, specificity, positive and negative predictive values of the tool using two cut-off values were calculated. Also, predictive properties of the SQ were calculated. In monitoring meetings and interviews, healthcare providers shared their experiences with the tool. Transcripts were deductively coded using six user experience domains: Acceptability, Satisfaction, Credibility, Usability, User-reported adherence and Perceived impact. Results: A total of 523 patients with COPD were included between May 2019 and August 2020, of whom 100 (19.1%) died within 12 months. The ProPal-COPD tool had an AUC of 0.68 and a low sensitivity (55%) and moderate specificity (74%) for predicting 1-year all-cause mortality. Using a lower cut-off value, sensitivity was higher (74%), but specificity lower (46%). Sensitivity and specificity of the SQ were 56% and 73%, respectively (AUC 0.65). However, healthcare providers generally appreciated using the tool because it increased awareness of the palliative phase and provided a shared understanding of prognosis, although they considered its outcome not always correct. Conclusion:The accuracy of the ProPal-COPD tool to predict 1-year mortality is limited, although screening patients with its indicators increases healthcare providers' awareness of palliative care needs and encourages them to timely initiate appropriate care.

show abstract

Section: Discussionmentioning

confidence: 99%

External Validation and User Experiences of the ProPal-COPD Tool to Identify the Palliative Phase in COPD

Broese

Kleij

Verschuur

et al. 2022

COPD

Self Cite

View full text Add to dashboard Cite

show abstract

“…The development of the original "I-HARP" has been described previously (Ament et al 2020). In short, the original "I-HARP" consisted of opening questions to start exploring palliative care needs followed by identification questions to identify palliative care needs.…”

Section: The Original "I-harp"mentioning

confidence: 99%

“…A study about palliative care for people with dementia has shown that easily disseminated conversation tool tailored to disease-specific elements increased the confidence of HCPs in initiating and discussing palliative care (Berry et al 2023). Previously, the research team developed such a conversation tool for patients with chronic heart failure (CHF), called "I-HARP" (Identification of patients with HeARt failure with palliative care needs) (Ament et al 2020). This original "I-HARP" supports HCPs to timely recognize, discuss, and direct palliative care needs of Dutch patients with CHF.…”

Section: Introductionmentioning

confidence: 99%

Development of the conversation tool “I-HARP for COPD” for early identification of palliative care needs in patients with chronic obstructive pulmonary disease

Huijten,

Hofstede,

Simons

et al. 2024

Pall Supp Care

View full text Add to dashboard Cite

Objectives This study aimed to develop the conversation tool “I-HARP for COPD” for timely identification of palliative care needs in Dutch patients with chronic obstructive pulmonary disease (COPD). Methods An iterative and participatory research design was used to develop “I-HARP for COPD”. There were 2 phases to the development of “I-HARP for COPD”: content development and testing. A review of current literature, parallel focus groups, and a questionnaire among experts were used to develop the content of “I-HARP for COPD”. “I-HARP for COPD” was then assessed by health-care professionals (HCPs) in clinical practice for understanding, difficulty, and relevance. Results A total of 46 HCPs, 6 patients, 1 informal caregiver, and 1 bereaved informal caregiver participated in this study. “I-HARP for COPD” included 14 screening questions, additional in-depth questions, and recommendations to address identified needs. The content of “I-HARP for COPD” was accepted by 86.2% of the HCPs. Significance of results “I-HARP for COPD” was successfully developed for providing guidance in the palliative care of Dutch patients with COPD and their informal caregivers. By supporting HCPs with “I-HARP for COPD”, they are better able to timely identify and direct palliative care needs.

show abstract

“…Indeed, people with HF experience physical symptoms such as breathlessness, fatigue, and poor appetite. 5 Informal caregivers of patients also experience poor outcomes such as increased psychosocial distress and poor well-being, 6 with a negative impact on their quality of life.…”

mentioning

confidence: 99%

“…Despite improvements in treatment, the outcomes in patients with HF remain poor, and this has consequences not only for patients with HF but also for their caregivers. Indeed, people with HF experience physical symptoms such as breathlessness, fatigue, and poor appetite 5 . Informal caregivers of patients also experience poor outcomes such as increased psychosocial distress and poor well-being, 6 with a negative impact on their quality of life.…”

mentioning

confidence: 99%

The Effectiveness of a Motivational Interviewing Intervention on Mutuality Between Patients With Heart Failure and Their Caregivers

et al. 2023

View full text Add to dashboard Cite

Background: Mutuality, defined as "the positive quality of the relationship between a caregiver and a care receiver", was found to be associated with self-care and caregiver contribution to self-care in heart failure (HF). However, no studies were conducted to evaluate whether motivational interviewing (MI) can improve mutuality in patients with HF and caregivers. Objectives: The aim of this study was to evaluate the effectiveness of MI on mutuality in HF patientcaregiver dyads. Methods: This is a secondary outcome analysis of the MOTIVATE-HF randomized controlled trial, the primary aim of which was to evaluate the effect of MI on improving self-care in patients with HF. Participants were randomized into 3 arms: (1) MI for patients only, (2) MI for both patients and caregivers, and (3) standard care. To assess the HF patients' and caregivers' mutuality, the Mutuality Scale was used in its patient and caregiver versions. Results: Patients with HF had a median age of 74 years, and there were more men (58%). Most patients were retired (76.2%). Caregivers had a median age of 55 years and were mostly women (75.5%). Most patients were in New York Heart Association class II (61.9%) and had an ischemic HF etiology (33.6%). The motivational interviews did not show any impact on changes in the patient and caregiver mutuality during the follow-up time (3, 6, 9, and 12 months from baseline). The condition of living together between the patient and the caregiver was significantly associated with better mutuality between the patient and the caregiver. Conclusions: Motivational interviewing performed by nurses

show abstract

Professionals guidance about palliative medicine in chronic heart failure: a mixed-method study

Cited by 6 publications

References 35 publications

External Validation and User Experiences of the ProPal-COPD Tool to Identify the Palliative Phase in COPD

External Validation and User Experiences of the ProPal-COPD Tool to Identify the Palliative Phase in COPD

Development of the conversation tool “I-HARP for COPD” for early identification of palliative care needs in patients with chronic obstructive pulmonary disease

The Effectiveness of a Motivational Interviewing Intervention on Mutuality Between Patients With Heart Failure and Their Caregivers

Contact Info

Product

Resources

About