Symptoms experienced in the last six months of life in patients with end-stage heart failure

Eur J Cardiovasc Nurs. 2003 Sep;2(3):213-7. doi: 10.1016/S1474-5151(03)00059-8.

Abstract

Background: Despite today's modern therapy, the advancement of chronic heart failure (CHF) has not been curbed (Dying from heart failure: lessons from palliative care, BMJ, 317, 1998, 961-962, Editorial). Consequently, the suffering in patients with end-stage CHF is still present. The knowledge on the frequency of symptoms in these patients is scarce.

Aims: The aim of this study was to achieve a deeper understanding of patients with end-stage CHF and to describe symptoms in these patients during the last 6 months of life by examining documentation in medical records.

Methods: The study adopted a descriptive, retrospective design using record reviews to collect data, in which 80 medical records of patients hospitalised for CHF in 1995 were reviewed. Descriptive statistics and Student's t-tests were performed.

Results: Breathlessness was the most common symptom (men 90%, women 86%). The largest gender difference was on limitation in physical activity (men=77%, women=37%, total=49%, P=0.001).

Conclusion: (1) Twenty-one symptoms were observed, implicating that, patients with CHF in later stages of the disease experience a wide range of symptoms. (2) Despite the fact that several symptoms were documented by both nurses and physicians, it is quite remarkable that symptom-controlling measures were only provided sparingly. (3) A palliative care approach may benefit patients suffering from end-stage CHF.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Anorexia / etiology
  • Anxiety / epidemiology
  • Anxiety / etiology*
  • Anxiety / prevention & control
  • Constipation / etiology
  • Cough / etiology
  • Documentation / standards
  • Dyspnea / epidemiology
  • Dyspnea / etiology*
  • Dyspnea / prevention & control
  • Fatigue / epidemiology
  • Fatigue / etiology*
  • Fatigue / prevention & control
  • Female
  • Heart Failure / complications*
  • Heart Failure / physiopathology
  • Heart Failure / psychology
  • Humans
  • Male
  • Nausea / etiology
  • Pain / epidemiology
  • Pain / etiology*
  • Pain / prevention & control
  • Palliative Care / methods
  • Retrospective Studies
  • Sex Distribution
  • Sleep Wake Disorders / etiology
  • Surveys and Questionnaires
  • Sweden / epidemiology