African American Heart Failure Patients’ Perspective on Palliative Care in the Outpatient Setting
Abstract
ABSTRACT
Background: Heart failure (HF) is a progressive, incurable, complex disease that limits both the physical and psychosocial qualities of life (Francis, Sonnenblick, Wilson Tang, & Poole-Wilson, 2008; Goldstein & Lynn, 2006). It is recommended that palliative care be used in conjunction with HF care guidelines to optimize the care of HF patients throughout the trajectory of the disease (Goodlin, 2009b; Jaarsma et al., 2009; Stuart, 2007). Purpose: To explore from the patient perspective, the understanding of, and feelings toward, palliative care in African American HF patients in an ambulatory cardiac care setting. Methods: A qualitative study using semi-structured interviews of 13African American HF patients from an ambulatory cardiac care center. Results: Overall, none of the 13 participants had heard of palliative care prior to the interview. After an explanation of palliative care was provided, 10 of 13 (77%) felt having palliative care involved in their HF treatment would be beneficial. Additionally the following three main themes emerged: 1) improved quality of life, 2) need for strong patient-provider relationships, and 3) need for ongoing education about the trajectory of their HF. Conclusion: Based on patient responses, early intervention of palliative care is needed in HF treatment to provide further emotional and psychosocial support, as well as relief of symptom burden. Participants expressed a need for strong patient-provider relationships and to have on-going education regarding their disease trajectory. Further research is needed to evaluate early palliative care intervention, patient satisfaction, and quality of life outcomes in the course of HF treatment.
Background: Heart failure (HF) is a progressive, incurable, complex disease that limits both the physical and psychosocial qualities of life (Francis, Sonnenblick, Wilson Tang, & Poole-Wilson, 2008; Goldstein & Lynn, 2006). It is recommended that palliative care be used in conjunction with HF care guidelines to optimize the care of HF patients throughout the trajectory of the disease (Goodlin, 2009b; Jaarsma et al., 2009; Stuart, 2007). Purpose: To explore from the patient perspective, the understanding of, and feelings toward, palliative care in African American HF patients in an ambulatory cardiac care setting. Methods: A qualitative study using semi-structured interviews of 13African American HF patients from an ambulatory cardiac care center. Results: Overall, none of the 13 participants had heard of palliative care prior to the interview. After an explanation of palliative care was provided, 10 of 13 (77%) felt having palliative care involved in their HF treatment would be beneficial. Additionally the following three main themes emerged: 1) improved quality of life, 2) need for strong patient-provider relationships, and 3) need for ongoing education about the trajectory of their HF. Conclusion: Based on patient responses, early intervention of palliative care is needed in HF treatment to provide further emotional and psychosocial support, as well as relief of symptom burden. Participants expressed a need for strong patient-provider relationships and to have on-going education regarding their disease trajectory. Further research is needed to evaluate early palliative care intervention, patient satisfaction, and quality of life outcomes in the course of HF treatment.
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