Barriers and facilitators to a ‘good death’ in heart failure: An integrative review

Asano, R; Abshire, M; Dennison-Himmelfarb, C; Davidson, PM

Barriers and facilitators to a ‘good death’ in heart failure: An integrative review

Asano, R Abshire, M Dennison-Himmelfarb, C Davidson, PM

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Publisher:: ELSEVIER
Publication Type:: Journal Article
Citation:: Collegian, 2019, 26, (6), pp. 651-665
Issue Date:: 2019-12-01

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Field	Value	Language
dc.contributor.author	Asano, R
dc.contributor.author	Abshire, M
dc.contributor.author	Dennison-Himmelfarb, C
dc.contributor.author	Davidson, PM
dc.date.accessioned	2022-09-08T22:57:35Z
dc.date.available	2022-09-08T22:57:35Z
dc.date.issued	2019-12-01
dc.identifier.citation	Collegian, 2019, 26, (6), pp. 651-665
dc.identifier.issn	1322-7696
dc.identifier.issn	1876-7575
dc.identifier.uri	http://hdl.handle.net/10453/161562
dc.description.abstract	Background: Heart failure is the final common pathway of many cardiovascular diseases, and yet many individuals with heart failure die hospitalised, suffering needlessly and experiencing what could be termed a ‘bad death’. While it is essential to address the wishes of individuals and their families in improving the quality of end-of-life care for patients with heart failure, their unmet needs remain poorly understood. Aim: To systematically review the literature describing a good death or end-of-life care in heart failure and to synthesise identified studies to describe how elements of heart failure care may contribute to a good death. Methods: PubMed and Scopus were searched from January 2001 to April 2018. The method of Whittemore and Knafl guided this review to identify emergent themes. Findings: Of the 436 studies identified, 43 met the inclusion criteria. Five themes associated with end-of-life care in heart failure and a good death were generated: (1) location of death, (2) preferred care, (3) palliative care utilisation, (4) interventions to improve the likelihood of a good death, (5) the intersection of individual, family, healthcare providers, and community-level factors. Discussion: This integrative review highlights a number of factors that prevent patients with heart failure from receiving palliative care, such as difficulty predicting mortality, late referral misconception of the role of palliative care and low availability of resources. Conclusion: This review has identified modifiable barriers and facilitator of a good death and emphasised the importance of considering the intersection of patient, provider and healthcare system issues in facilitating a good death for patients with heart failure.
dc.language	English
dc.publisher	ELSEVIER
dc.relation.ispartof	Collegian
dc.relation.isbasedon	10.1016/j.colegn.2019.09.010
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1110 Nursing
dc.subject.classification	Nursing
dc.title	Barriers and facilitators to a ‘good death’ in heart failure: An integrative review
dc.type	Journal Article
utslib.citation.volume	26
utslib.for	1110 Nursing
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
utslib.copyright.status	closed_access	*
dc.date.updated	2022-09-08T22:57:29Z
pubs.issue	6
pubs.publication-status	Published
pubs.volume	26
utslib.citation.issue	6

Abstract:

Background: Heart failure is the final common pathway of many cardiovascular diseases, and yet many individuals with heart failure die hospitalised, suffering needlessly and experiencing what could be termed a ‘bad death’. While it is essential to address the wishes of individuals and their families in improving the quality of end-of-life care for patients with heart failure, their unmet needs remain poorly understood. Aim: To systematically review the literature describing a good death or end-of-life care in heart failure and to synthesise identified studies to describe how elements of heart failure care may contribute to a good death. Methods: PubMed and Scopus were searched from January 2001 to April 2018. The method of Whittemore and Knafl guided this review to identify emergent themes. Findings: Of the 436 studies identified, 43 met the inclusion criteria. Five themes associated with end-of-life care in heart failure and a good death were generated: (1) location of death, (2) preferred care, (3) palliative care utilisation, (4) interventions to improve the likelihood of a good death, (5) the intersection of individual, family, healthcare providers, and community-level factors. Discussion: This integrative review highlights a number of factors that prevent patients with heart failure from receiving palliative care, such as difficulty predicting mortality, late referral misconception of the role of palliative care and low availability of resources. Conclusion: This review has identified modifiable barriers and facilitator of a good death and emphasised the importance of considering the intersection of patient, provider and healthcare system issues in facilitating a good death for patients with heart failure.

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http://hdl.handle.net/10453/161562