What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study

S.M.C. Ament; L.M. van den Broek; M.H.J. Van den Beuken-van Everdingen; J.J.J. Boyne; J.M.C. Maessen; S.C.A.M. Bekkers; L. Bellersen; H.P. Brunner-La Rocca; Y. Engels; D.J.A. Janssen

doi:10.1186/s12904-021-00896-y

What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study

S.M.C. Ament, L.M. van den Broek, M.H.J. Van den Beuken-van Everdingen, J.J.J. Boyne, J.M.C. Maessen, S.C.A.M. Bekkers, L. Bellersen, H.P. Brunner-La Rocca, Y. Engels, D.J.A. Janssen^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background Needs assessment tools can facilitate healthcare professionals in timely recognition of palliative care needs. Despite the increased attention for implementation of such tools, most studies provide little or no attention to the context of implementation. The aim of this study was to explore factors that contribute positively and negatively to timely screening of palliative care needs in advanced chronic heart failure. Methods Qualitative study using individual interviews and focus groups with healthcare professionals. The data were analysed using a deductive approach. The Consolidated Framework for Implementation Research was used to conceptualise the contextual factors. Results Twenty nine healthcare professionals with different backgrounds and working in heart failure care in the Southern and Eastern parts of the Netherlands participated. Several factors were perceived to play a role, such as perception and knowledge about palliative care, awareness of palliative care needs in advanced chronic heart failure, perceived difficulty when and how to start palliative care, limited acceptance to treatment boundaries in cardiology, limited communication and collaboration between healthcare professionals, and need for education and increased attention for palliative care in advanced chronic heart failure guidelines. Conclusions This study clarified critical factors targeting patients, healthcare professionals, organisations to implement a needs assessment tool for timely recognition of palliative care needs in the context of advanced chronic heart failure. A multifaceted implementation strategy is needed which has attention for education, patient empowerment, interdisciplinary collaboration, identification of local champions, chronic heart failure specific guidelines and culture.

Original language	English
Article number	1
Number of pages	9
Journal	BMC Palliative Care
Volume	21
Issue number	1
DOIs	https://doi.org/10.1186/s12904-021-00896-y
Publication status	Published - 4 Jan 2022

Keywords

End-of-life
Palliative medicine
Congestive heart failure
Implementation
REPORTED OUTCOME INTERVENTION
ACCEPTABILITY
ILLNESS
PEOPLE

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Ament, S. M. C., van den Broek, L. M., Van den Beuken-van Everdingen, M. H. J., Boyne, J. J. J., Maessen, J. M. C., Bekkers, S. C. A. M., Bellersen, L., Brunner-La Rocca, H. P., Engels, Y., & Janssen, D. J. A. (2022). What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study. BMC Palliative Care, 21(1), Article 1. https://doi.org/10.1186/s12904-021-00896-y

@article{a237489d2f7d466a96f270aead6ec2e9,

title = "What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study",

abstract = "Background Needs assessment tools can facilitate healthcare professionals in timely recognition of palliative care needs. Despite the increased attention for implementation of such tools, most studies provide little or no attention to the context of implementation. The aim of this study was to explore factors that contribute positively and negatively to timely screening of palliative care needs in advanced chronic heart failure. Methods Qualitative study using individual interviews and focus groups with healthcare professionals. The data were analysed using a deductive approach. The Consolidated Framework for Implementation Research was used to conceptualise the contextual factors. Results Twenty nine healthcare professionals with different backgrounds and working in heart failure care in the Southern and Eastern parts of the Netherlands participated. Several factors were perceived to play a role, such as perception and knowledge about palliative care, awareness of palliative care needs in advanced chronic heart failure, perceived difficulty when and how to start palliative care, limited acceptance to treatment boundaries in cardiology, limited communication and collaboration between healthcare professionals, and need for education and increased attention for palliative care in advanced chronic heart failure guidelines. Conclusions This study clarified critical factors targeting patients, healthcare professionals, organisations to implement a needs assessment tool for timely recognition of palliative care needs in the context of advanced chronic heart failure. A multifaceted implementation strategy is needed which has attention for education, patient empowerment, interdisciplinary collaboration, identification of local champions, chronic heart failure specific guidelines and culture.",

keywords = "End-of-life, Palliative medicine, Congestive heart failure, Implementation, REPORTED OUTCOME INTERVENTION, ACCEPTABILITY, ILLNESS, PEOPLE",

author = "S.M.C. Ament and {van den Broek}, L.M. and {Van den Beuken-van Everdingen}, M.H.J. and J.J.J. Boyne and J.M.C. Maessen and S.C.A.M. Bekkers and L. Bellersen and {Brunner-La Rocca}, H.P. and Y. Engels and D.J.A. Janssen",

note = "Funding Information: This project has been made possible by a grant from the Netherlands Organisation for Health Research and Development (ZonMw) as part of the programme Palliantie (grant number 844001511). The NAT-PF:HF pilot project was supported by the Stoffels-Hornstra Foundation, the Hague, The Netherlands. The sponsor had no role in the design of the study, the data collection, data analysis, in the interpretation of the data, or in the writing of the manuscript. Funding Information: The authors would like to acknowledge the contributions of Mrs. Liesbeth Van Hoef (Department of Patient and Care, Maastricht University Medical Centre, Maastricht, the Netherlands), Mrs. Wendy Engering (Department of Patient and Care, Maastricht University Medical Centre, Maastricht, the Netherlands), Mrs. Inge Couwenberg (department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands) to the transcriptions and data-analyses. Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = jan,

day = "4",

doi = "10.1186/s12904-021-00896-y",

language = "English",

volume = "21",

journal = "BMC Palliative Care",

issn = "1472-684X",

publisher = "BioMed Central Ltd",

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Ament, SMC, van den Broek, LM, Van den Beuken-van Everdingen, MHJ , Boyne, JJJ, Maessen, JMC, Bekkers, SCAM, Bellersen, L, Brunner-La Rocca, HP, Engels, Y & Janssen, DJA 2022, 'What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study', BMC Palliative Care, vol. 21, no. 1, 1. https://doi.org/10.1186/s12904-021-00896-y

TY - JOUR

T1 - What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study

AU - Ament, S.M.C.

AU - van den Broek, L.M.

AU - Van den Beuken-van Everdingen, M.H.J.

AU - Boyne, J.J.J.

AU - Maessen, J.M.C.

AU - Bekkers, S.C.A.M.

AU - Bellersen, L.

AU - Brunner-La Rocca, H.P.

AU - Engels, Y.

AU - Janssen, D.J.A.

N1 - Funding Information: This project has been made possible by a grant from the Netherlands Organisation for Health Research and Development (ZonMw) as part of the programme Palliantie (grant number 844001511). The NAT-PF:HF pilot project was supported by the Stoffels-Hornstra Foundation, the Hague, The Netherlands. The sponsor had no role in the design of the study, the data collection, data analysis, in the interpretation of the data, or in the writing of the manuscript. Funding Information: The authors would like to acknowledge the contributions of Mrs. Liesbeth Van Hoef (Department of Patient and Care, Maastricht University Medical Centre, Maastricht, the Netherlands), Mrs. Wendy Engering (Department of Patient and Care, Maastricht University Medical Centre, Maastricht, the Netherlands), Mrs. Inge Couwenberg (department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands) to the transcriptions and data-analyses. Publisher Copyright: © 2022, The Author(s).

PY - 2022/1/4

Y1 - 2022/1/4

N2 - Background Needs assessment tools can facilitate healthcare professionals in timely recognition of palliative care needs. Despite the increased attention for implementation of such tools, most studies provide little or no attention to the context of implementation. The aim of this study was to explore factors that contribute positively and negatively to timely screening of palliative care needs in advanced chronic heart failure. Methods Qualitative study using individual interviews and focus groups with healthcare professionals. The data were analysed using a deductive approach. The Consolidated Framework for Implementation Research was used to conceptualise the contextual factors. Results Twenty nine healthcare professionals with different backgrounds and working in heart failure care in the Southern and Eastern parts of the Netherlands participated. Several factors were perceived to play a role, such as perception and knowledge about palliative care, awareness of palliative care needs in advanced chronic heart failure, perceived difficulty when and how to start palliative care, limited acceptance to treatment boundaries in cardiology, limited communication and collaboration between healthcare professionals, and need for education and increased attention for palliative care in advanced chronic heart failure guidelines. Conclusions This study clarified critical factors targeting patients, healthcare professionals, organisations to implement a needs assessment tool for timely recognition of palliative care needs in the context of advanced chronic heart failure. A multifaceted implementation strategy is needed which has attention for education, patient empowerment, interdisciplinary collaboration, identification of local champions, chronic heart failure specific guidelines and culture.

AB - Background Needs assessment tools can facilitate healthcare professionals in timely recognition of palliative care needs. Despite the increased attention for implementation of such tools, most studies provide little or no attention to the context of implementation. The aim of this study was to explore factors that contribute positively and negatively to timely screening of palliative care needs in advanced chronic heart failure. Methods Qualitative study using individual interviews and focus groups with healthcare professionals. The data were analysed using a deductive approach. The Consolidated Framework for Implementation Research was used to conceptualise the contextual factors. Results Twenty nine healthcare professionals with different backgrounds and working in heart failure care in the Southern and Eastern parts of the Netherlands participated. Several factors were perceived to play a role, such as perception and knowledge about palliative care, awareness of palliative care needs in advanced chronic heart failure, perceived difficulty when and how to start palliative care, limited acceptance to treatment boundaries in cardiology, limited communication and collaboration between healthcare professionals, and need for education and increased attention for palliative care in advanced chronic heart failure guidelines. Conclusions This study clarified critical factors targeting patients, healthcare professionals, organisations to implement a needs assessment tool for timely recognition of palliative care needs in the context of advanced chronic heart failure. A multifaceted implementation strategy is needed which has attention for education, patient empowerment, interdisciplinary collaboration, identification of local champions, chronic heart failure specific guidelines and culture.

KW - End-of-life

KW - Palliative medicine

KW - Congestive heart failure

KW - Implementation

KW - REPORTED OUTCOME INTERVENTION

KW - ACCEPTABILITY

KW - ILLNESS

KW - PEOPLE

U2 - 10.1186/s12904-021-00896-y

DO - 10.1186/s12904-021-00896-y

M3 - Article

C2 - 34980105

SN - 1472-684X

VL - 21

JO - BMC Palliative Care

JF - BMC Palliative Care

IS - 1

M1 - 1

ER -

What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study

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Keywords

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