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Patients’ experiences of person-centred integrated heart failure care and palliative care at home: an interview study
  1. Naghada Talabani1,
  2. Karin Hellström Ängerud2,
  3. Kurt Boman3,4 and
  4. Margareta Brännström2,5,6
  1. 1Department of Cardiology M82, Karolinska University Hospital, Stockholm, Sweden
  2. 2Department of Nursing, Umeå University, Umeå, Sweden
  3. 3Research Unit Skellefteå, Department of Medicine, Umeå University, Skellefteå, Sweden
  4. 4Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
  5. 5The Arctic Research Centre, Umeå University, Umeå, Sweden
  6. 6Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
  1. Correspondence to Dr Margareta Brännström, Department of Nursing, Umeå University, Campus Skellefteå, SE-901 86 Skellefteå, Sweden; margareta.brannstrom{at}umu.se

Abstract

Objectives Patients with severe heart failure (HF) suffer from a high symptom burden and high mortality. European and Swedish guidelines for HF care recommend palliative care for these patients. Different models for integrated palliative care and HF care have been described in the literature. No studies were found that qualitatively evaluated these models. The purpose of this study is to describe patients' experiences of a new model of person-centred integrated HF and palliative care at home.

Method Interviews were conducted with 12 patients with severe HF (New York Heart Association class III–IV) and included in the research project of Palliative advanced home caRE and heart FailurE caRe (PREFER). Qualitative content analysis was used for data analysis.

Results Two themes and a total of five categories were identified. The first theme was feeling secure and safe through receiving care at home with the categories: having access to readily available care at home, being followed up continuously and having trust in the team members' ability to help. The second theme was being acknowledged as both a person and a patient, with the following two categories: being met as a person, participating in decisions about one's care and receiving help for symptoms of both HF and comorbidities.

Conclusions Person-centred integrated HF and palliative care provides a secure environment and holistic care for patients with severe HF. This approach is a way to improve the care management in this population.

Trial registration number NCT01304381; Results.

  • clinical intervention
  • heart failure
  • palliative care
  • patient
  • person-centred care
  • Received 26 August 2016.
  • Revision received 27 May 2017.
  • Accepted 31 May 2017.

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  • Received 26 August 2016.
  • Revision received 27 May 2017.
  • Accepted 31 May 2017.
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Footnotes

  • Contributors NT: analysis and interpretation of the data, drafting of the manuscript. MB: conception and design of the research, acquisition of data, obtained funding and has done critical revision of the manuscript and supervised the study. KHÃ: critical revision of the manuscript and supervised the study. KB: obtained funding and has done critical revision of the manuscript.

  • Funding This study was supported by the Swedish Association of Local Authorities and Regions, the Strategic Research Program in Health Care Sciences (SFO-V), ‘Bridging Research and Practice for Better Health, Sweden’, the Foundation for Medical Research in Skellefteå, the King Gustaf V and Queen Victoria’s Foundation and the Rönnbäret Fund, Skellefteå Municipality.

  • Competing interests None declared.

  • Patient consent Obtained

  • Ethics approval This study conforms to the principals in thedeclaration of Helsinki[23] and was approved by theRegional Ethical Review board in Umeå (dnr 2010-294-31M).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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