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 IIIâ€“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
- person-centred care
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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.
Ethics approval This study conforms to the principals in thedeclaration of Helsinki and was approved by theRegional Ethical Review board in Umeå (dnr 2010-294-31M).
Provenance and peer review Not commissioned; externally peer reviewed.