Prognosis Communication in Heart Failure: Experiences and Preferences of End-Stage Heart Failure Patients and Care Partners
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Le résumé fourni par la source
BACKGROUND: Patients with heart failure (HF) overestimate survival compared with model-predicted estimates, but the reasons for this discrepancy are poorly understood. We characterized how patients with end-stage HF and their care partners understand prognosis and elicited their preferences around prognosis communication. METHODS: We conducted in-depth, semistructured interviews with patients with end-stage HF and their care partners between 2021 and 2022 at a tertiary care center in Michigan. Participants were asked to describe barriers they faced to understanding prognosis. All interviews were coded and analyzed using an iterative content analysis approach. RESULTS: Fifteen patients with end-stage HF and 15 care partners participated, including 7 dyads. The median patient age was 66.5 years (range, 31-80) and included 9 of 15 (60%) White participants and 9 of 15 (60%) were males. Care partners included 10 of 15 (67%) White participants and 6 of 15 (40%) were males. Care partners were partners (n=7, 47%), siblings (n=4, 27%), parents (n=2, 13%), and children (n=2, 13%). Most patients demonstrated a poor understanding of their prognosis. In contrast, care partners commonly identified the patient's rapidly declining trajectory. Patients and care partners described ineffective prognosis communication with clinicians, common barriers to understanding prognosis, and similar suggestions on improving prognosis communication. Barriers to understanding prognosis included (1) conversation avoidance by physicians, (2) information inconsistency across different physicians, (3) distractions during prognosis communication due to emphasis on other conditions, and (4) confusion related to the use of medical jargon. Most patients and care partners wanted discussions around prognosis to begin early in the course of the disease, repeated routinely using layperson's terms, incorporating both quality of life and survival assessments, and involving care partners. Both patients and care partners did not expect precise survival estimates. CONCLUSIONS: Patients with end-stage HF demonstrate a poor understanding of their prognosis compared with their care partners. Patients and care partners are open to discussing prognosis early, using direct and patient-centered language.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Prognosis Communication in Heart Failure: Experiences and Preferences of End-Stage Heart Failure Patients and Care Partners
- Date Crossref
- 01/06/2024
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Michigan Department of Internal Medicine (S.S. pays non établi dans la noticeUniversité ou école supérieure
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VA Center for Clinical Management Research pays non établi dans la noticeÉtablissement de santé
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VA Ann Arbor Healthcare System pays non établi dans la noticeÉtablissement de santé
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Michigan Medicine pays non établi dans la noticeÉtablissement de santé
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University of Colorado Anschutz Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
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University of Colorado Denver pays non établi dans la noticeUniversité ou école supérieure
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Institute for Social Research pays non établi dans la noticeStructure de recherche
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Center for Clinical Management Research (M.H.) pays non établi dans la noticeÉtablissement de santé
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Geriatric Research and Clinical Center (A.V.) pays non établi dans la noticeÉtablissement de santé
Department of Internal Medicine (S.S. — University of Michigan, VA Center for Clinical Management Research et VA Ann Arbor Healthcare System, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.