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


OBJECTIVE
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).


CONCLUSIONS
(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.
Nordgren
Lena
L
Department of Caring and Public Health Sciences, Mälardalen University, Västerås, Karpvägen 6, Kvicksund 640 45, Sweden. lena.nordgren@mdh.se
Sörensen
Stefan
S
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000855:Anorexia / Q000209:etiology; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D003248:Constipation / Q000209:etiology; D003371:Cough / Q000209:etiology; D004282:Documentation / Q000592:standards; D004417:Dyspnea / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D009325:Nausea / Q000209:etiology; D010146:Pain / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D010166:Palliative Care / Q000379:methods; D012189:Retrospective Studies; D017678:Sex Distribution; D012893:Sleep Wake Disorders / Q000209:etiology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology