Symptom burden, psychosocial distress and palliative care needs in heart failure – A cross-sectional explorative pilot study

Strangl, Felix; Ischanow, E; Ullrich, Anneke; Fluschnik, Nina; Magnussen, Christina; Knappe, Dorit; Grahn, Hanno; Blankenberg, Stefan; Bokemeyer, Carsten; Kirchhof, Paulus; Rybczynski, Meike

doi:10.1007/s00392-022-02017-y

Cited by 8 publications

(3 citation statements)

References 46 publications

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“…These patients have a significant burden of symptoms in each stage of the disease, which necessitates palliative care. [ 30 ] The health system staff should also consider providing care according to the values, expectations, and preferences of these patients at the end of life. [ 31 ] Therefore, it seems necessary to familiarize nurses with the management of this chronic disease and the provision of supportive and end-of-life care services.…”

Section: Discussionmentioning

confidence: 99%

Development of a Heart Failure Palliative Care Educational Program for Nurses: A Multi-Method Approach

Bagheri,

Irajpour,

Hashemi

2024

Iranian Journal of Nursing and Midwifery Research

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Background: Comprehensive palliative care for patients with heart failure can be developed by educating cardiac nurses. The current study aimed to design a heart failure palliative care educational program for nurses. Materials and Methods: This study was carried out using the multi-method approach based on two out of four steps of Uys educational program development at Dr. Chamran Hospital, Isfahan, in 2020–2021. In step 1, educational needs were collected through literature review, interviews with 15 patients and 10 nurses, examination of patients’ documents and medical records, and observation. Then, in step 2, the importance and necessity of teaching the proposed topics and the teaching and evaluation method of the items were assessed through two rounds of delphi technique (15 expert panel members). Eventually, the educational program was finalized. Results: In step 1, the educational needs of nurses were identified in 6 general fields and 26 general learning topics. In step 2, educational needs [specialized knowledge (55% necessity and 55% importance) and social support (33% necessity and 33% importance)], teaching methods (role-playing, experiential learning, and journal club), and evaluation method (the information analysis method) were removed due to a lack of consensus (11%). Finally, the main parts of the program, including the program mission and vision, general learning topics, general goals, objectives, teaching strategies, and evaluation strategies, were compiled. Conclusions: This program provides nurses with up-to-date information on various aspects of the physical, psychological, social, spiritual, and educational needs of heart failure patients and ensures the provision of better services to them.

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Section: Discussionmentioning

confidence: 99%

Development of a Heart Failure Palliative Care Educational Program for Nurses: A Multi-Method Approach

Bagheri,

Irajpour,

Hashemi

2024

Iranian Journal of Nursing and Midwifery Research

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“…This PHQ-4 measure has been used to screen for anxiety and depression symptoms in caregiving studies. 35,36…”

Section: Methodsmentioning

confidence: 99%

“…This PHQ-4 measure has been used to screen for anxiety and depression symptoms in caregiving studies. 35,36 Caregiver outcomes (dependent variables measures). Caregiving burden was measured by the 12-item, 5-point Likerttype scale Zarit Burden Interview, version 12 (ZBI-12).…”

Section: Measures For Research Question 1 (Quantitative Variables)mentioning

confidence: 99%

Family Caregiving of Patients With Heart Failure and Vascular Dementia in Rural Appalachia: A Mixed-Methods Study

Piamjariyakul,

Wang,

Smith

et al. 2024

West J Nurs Res

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Introduction: Vascular dementia and heart failure (HF) are common co-existing conditions among adult populations. Each condition requires extensive home caregiving from family caregivers, especially those in rural Appalachia. This study aimed to assess caregivers’ burden and their physical and mental health status, as well as explore their experiences and needs. Methods: This study used an exploratory mixed-methods design combining quantitative and qualitative research (N = 20 caregivers). We collected data using questionnaires, short-answered interviews, and focus group discussions. The multivariable generalized linear model (GLiM) was used to analyze quantitative data; content analysis was used for qualitative data. Results: The average age of family caregivers was 64.95 years. The generalized linear model showed that the caregiving burden was associated with caregivers’ depression/anxiety ( r = 0.68, P < .001) and their number of dementia caregiving years ( r = 0.54, P < .05). Caregivers’ poor physical health status was associated with better preparedness for HF and dementia home caregiving ( r = 0.52, P < .05) and male caregivers ( r = −0.46, P < .01). Caregivers’ mental health status was associated with depression/anxiety ( r = −0.80, P < .001). The qualitative data identified key caregiving themes: emotional impact and physical demands of caregiving, lack of help in rural areas, dealing with multiple disease progression, and relationship changes with their loved ones. Conclusion: Caregiving burden was associated with caregivers’ home care responsibilities and the need for support. Nurse-led home caregiving preparedness interventions tailored for family caregivers of patients with HF and dementia in rural areas are recommended.

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In-hospital bioimpedance-derived total body water predicts short-term cardiovascular mortality and re-hospitalizations in acute decompensated heart failure patients

Faragli,

Herrmann,

Cvetkovic

et al. 2024

Clin Res Cardiol

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Background Hospital re-admissions in heart failure (HF) patients are mostly caused by an acute exacerbation of their chronic congestion. Bioimpedance analysis (BIA) has emerged as a promising non-invasive method to assess the volume status in HF. However, its correlation with clinically assessed volume status and its prognostic value in the acute intra-hospital setting remains uncertain. Methods and results In this single-center observational study, patients (n = 49) admitted to the cardiology ward for acute decompensated HF (ADHF) underwent a daily BIA-derived volume status assessment. Median hospital stay was 7 (4–10) days. Twenty patients (40%) reached the composite endpoint of cardiovascular mortality or re-hospitalization for HF over 6 months. Patients at discharge displayed improved NYHA class, lower body weight, plasma and blood volume, as well as lower NT-proBNP levels compared to the admission. Compared to patients with total body water (TBW) less than or equal to that predicted by body weight, those with higher relative TBW levels had elevated NT-proBNP and E/e´ (both p < 0.05) at discharge. In the Cox multivariate regression analysis, the BIA-derived delta TBW between admission and discharge showed a 23% risk reduction for each unit increase (HR = 0.776; CI 0.67–0.89; p = 0.0006). In line with this finding, TBW at admission had the highest prediction importance of the combined endpoint for a subgroup of high-risk HF patients (n = 35) in a neural network analysis. Conclusion In ADHF patients, BIA-derived TBW is associated with the increased risk of HF hospitalization or cardiovascular death over 6 months. The role of BIA for prognostic stratification merits further investigation.

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Symptom burden, psychosocial distress and palliative care needs in heart failure – A cross-sectional explorative pilot study

Cited by 8 publications

References 46 publications

Development of a Heart Failure Palliative Care Educational Program for Nurses: A Multi-Method Approach

Development of a Heart Failure Palliative Care Educational Program for Nurses: A Multi-Method Approach

Family Caregiving of Patients With Heart Failure and Vascular Dementia in Rural Appalachia: A Mixed-Methods Study

In-hospital bioimpedance-derived total body water predicts short-term cardiovascular mortality and re-hospitalizations in acute decompensated heart failure patients

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