TY - JOUR
T1 - Timely recognition of palliative care needs of patients with advanced chronic heart failure
T2 - a pilot study of a Dutch translation of the Needs Assessment Tool: Progressive Disease - Heart Failure (NAT:PD-HF)
AU - Janssen, Daisy J. A.
AU - Boyne, Josiane
AU - Currow, David C.
AU - Schols, Jos M. G. A.
AU - Johnson, Miriam J.
AU - Brunner-La Rocca, H-P
N1 - Funding Information:
The authors are grateful to Mrs Arja van de Voorde, research assistant for collection and input of the data. The authors are grateful to the HFNSs of the Maastricht University Medical Centre, Maastricht, The Netherlands, for their contributions to this study. This project was supported by the Stoffels-Hornstra Foundation, the Hague, The Netherlands.
Funding Information:
This project was supported by the Stoffels-Hornstra Foundation, the Hague, The Netherlands.
Publisher Copyright:
© The European Society of Cardiology 2019.
PY - 2019/6
Y1 - 2019/6
N2 - Background: The Needs Assessment Tool: Progressive Disease - Heart Failure (NAT:PD-HF) was developed to identify and triage palliative care needs in patients with chronic heart failure. A Dutch version is currently lacking. Aims: The aim of this study was to investigate the feasibility and acceptability of a Dutch NAT:PD-HF in chronic heart failure outpatients; and to gain preliminary data regarding the effect of the NAT:PD-HF on palliative care referral, symptoms, health status, care dependency, caregiver burden and advance directives. Methods: A mixed methods study including 23 outpatients with advanced chronic heart failure and 20 family caregivers was performed. Nurses conducted patient consultations using a Dutch translation of the NAT:PD-HF and rated acceptability. Before this visit and 4 months later, symptoms, health status, performance status, care dependency, caregiver burden and recorded advance directives were assessed. A focus group with participating nurses discussed barriers and facilitators towards palliative care needs assessment. Results: Acceptability was rated as 7 (interquartile range 6-7 points) on a 10-point scale. All patients had palliative care needs. In 48% actions were taken, including two patients referred to palliative care. Symptoms, performance status, care dependency, caregiver burden and advance directives were unchanged at 4 months, while health status deteriorated in patients completing follow-up (n=17). Barriers towards palliative care needs assessment included feeling uncomfortable to initiate discussions and concerns about the ability to address palliative care needs. Conclusions: The NAT:PD-HF identified palliative care needs in all participants, and triggered action to address these in half. However, training in palliative care communication skills as well as palliative care interventions should accompany the introduction of a palliative care needs assessment tool. Netherlands National Trial Register (NTR): 5616.
AB - Background: The Needs Assessment Tool: Progressive Disease - Heart Failure (NAT:PD-HF) was developed to identify and triage palliative care needs in patients with chronic heart failure. A Dutch version is currently lacking. Aims: The aim of this study was to investigate the feasibility and acceptability of a Dutch NAT:PD-HF in chronic heart failure outpatients; and to gain preliminary data regarding the effect of the NAT:PD-HF on palliative care referral, symptoms, health status, care dependency, caregiver burden and advance directives. Methods: A mixed methods study including 23 outpatients with advanced chronic heart failure and 20 family caregivers was performed. Nurses conducted patient consultations using a Dutch translation of the NAT:PD-HF and rated acceptability. Before this visit and 4 months later, symptoms, health status, performance status, care dependency, caregiver burden and recorded advance directives were assessed. A focus group with participating nurses discussed barriers and facilitators towards palliative care needs assessment. Results: Acceptability was rated as 7 (interquartile range 6-7 points) on a 10-point scale. All patients had palliative care needs. In 48% actions were taken, including two patients referred to palliative care. Symptoms, performance status, care dependency, caregiver burden and advance directives were unchanged at 4 months, while health status deteriorated in patients completing follow-up (n=17). Barriers towards palliative care needs assessment included feeling uncomfortable to initiate discussions and concerns about the ability to address palliative care needs. Conclusions: The NAT:PD-HF identified palliative care needs in all participants, and triggered action to address these in half. However, training in palliative care communication skills as well as palliative care interventions should accompany the introduction of a palliative care needs assessment tool. Netherlands National Trial Register (NTR): 5616.
KW - Palliative care
KW - needs
KW - assessment
KW - chronic heart failure
KW - caregiver
KW - communication
KW - HEALTH-CARE
KW - COMMUNICATION
KW - INTERVENTION
KW - COPD
KW - QUESTIONNAIRE
KW - CONSULTATION
KW - VALIDATION
KW - NURSES
U2 - 10.1177/1474515119831510
DO - 10.1177/1474515119831510
M3 - Article
C2 - 30760021
SN - 1474-5151
VL - 18
SP - 375
EP - 388
JO - European Journal of Cardiovascular Nursing
JF - European Journal of Cardiovascular Nursing
IS - 5
ER -