Referral for palliative care in advanced heart failure

被引:5
作者
Albert, Nancy M. [1 ]
机构
[1] Cleveland Clin, Kaufman Ctr Heart Failure, Nursing Inst, 9500 Euclid Ave,Mail code P32, Cleveland, OH 44195 USA
关键词
advanced heart failure; end of life; referral guidelines; palliative care; prognosis; hospice;
D O I
10.1179/096992608X297012
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Heart failure is a serious clinical condition that may be challenging to treat near end of life due to symptom burden, psychological concerns and social support issues. Referral for palliative care is uncommon and, when a patient is referred for services, it may occur very close to the patient's death, limiting palliative and support services associated with specialty programs. Chronic heart failure management guidelines were developed by heart failure experts and based on best evidence. However, since evidence in end-of-life and palliative care themes are limited, current heart failure guidelines specific to end of life and palliation are also limited in scope and detail. Many guidelines do not specify prognostic markers or other indicators for referral or consultation with palliative medicine teams. Likewise, many do not emphasize supportive care beyond management of dyspnea and pain. This paper describes current issues that limit referral to palliative care and offers insight for opportunities to improve patient-centered care through research.
引用
收藏
页码:220 / 228
页数:9
相关论文
共 40 条
[1]  
Albert Nancy M, 2007, Prog Cardiovasc Nurs, V22, P63, DOI 10.1111/j.0889-7204.2007.06539.x
[2]  
Albert NM, 2005, PALLIATIVE PRACTICES, P121
[3]  
*AM HEART ASS, 2007, HEART DIS STROK STAT
[4]   Canadian Cardiovascular Society Consensus Conference recommendations on heart failure update 2007: Prevention, management during intercurrent illness or acute decompensation, and use of biomarkers [J].
Arnold, J. Malcolm O. ;
Howlett, Jonathan G. ;
Dorian, Paul ;
Ducharme, Anique ;
Giannetti, Nadia ;
Haddad, Haissam ;
Heckman, George A. ;
Ignaszewski, Andrew ;
Isaac, Debra ;
Jong, Philip ;
Liu, Peter ;
Mann, Elizabeth ;
McKelvie, Robert S. ;
Moe, Gordon W. ;
Parker, John D. ;
Svendsen, Anna M. ;
Tsuyuki, Ross T. ;
O'Halloran, Kelly ;
Ross, Heather J. ;
Rao, Vivek ;
Sequeira, Errol J. ;
White, Michel .
CANADIAN JOURNAL OF CARDIOLOGY, 2007, 23 (01) :21-45
[5]   Canadian Cardiovascular Society consensus conference recommendations on heart failure 2006: Diagnosis and management [J].
Arnold, JMO ;
Liu, P ;
Demers, C ;
Dorian, P ;
Giannetti, N ;
Haddad, H ;
Heckman, GA ;
Howlett, JG ;
Ignaszewski, A ;
Johnstone, DE ;
Jong, P ;
McKelvie, RS ;
Moe, GW ;
Parker, JD ;
Rao, V ;
Ross, HJ ;
Sequeira, EJ ;
Svendsen, AM ;
Teo, K ;
Tsuyuki, RT ;
White, M .
CANADIAN JOURNAL OF CARDIOLOGY, 2006, 22 (01) :23-45
[6]  
Brock D B, 1998, Hosp J, V13, P49
[7]   Lack of concordance between physician and patient: Reports on end-of-life care discussions [J].
DesHarnais, Susan ;
Carter, Rickey E. ;
Hennessy, Winnie ;
Kurent, Jerome E. ;
Carter, Cindy .
JOURNAL OF PALLIATIVE MEDICINE, 2007, 10 (03) :728-740
[8]   The challenge of patients' unmet palliative care needs in the final stages of chronic illness [J].
Fitzsimons, D. ;
Mullan, D. ;
Wilson, J. S. ;
Conway, B. ;
Corcoran, B. ;
Dempster, M. ;
Gamble, J. ;
Stewart, C. ;
Rafferty, S. ;
McMahon, M. ;
MacMahon, J. ;
Mulholland, P. ;
Stockdalle, P. ;
Chew, E. ;
Hanna, L. ;
Brown, J. ;
Ferguson, G. ;
Fogarty, D. .
PALLIATIVE MEDICINE, 2007, 21 (04) :313-322
[9]   Risk stratification for in-hospital mortality in acutely decompensated heart failure - Classification and regression tree analysis [J].
Fonarow, GC ;
Adams, KF ;
Abraham, WT ;
Yancy, CW ;
Boscardin, WJ .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 293 (05) :572-580
[10]   Association between performance measures and clinical outcomes for patients hospitalized with heart failure [J].
Fonarow, Gregg C. ;
Abraham, William T. ;
Albert, Nancy M. ;
Stough, Wendy Gattis ;
Gheorghiade, Mihai ;
Greenberg, Barry H. ;
O'Connor, Christopher M. ;
Pieper, Karen ;
Sun, Jie Lena ;
Yancy, Clyde ;
Young, James B. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2007, 297 (01) :61-70