Patient work in end-stage heart failure: a prospective longitudinal multiple case study.
OBJECTIVE
The most recent WHO definition of palliative care regards living as actively as possible as an important aim. We explored, over a 1-year period, the work this involves for patients with end-stage heart failure.


METHODS
Prospective longitudinal multiple case study using qualitative interview techniques.


METHODS
Thirty-one respondents from two hospitals who fulfilled one or more of the following criteria: NYHA III or IV, ejection fraction <25%, at least one hospitalization for heart failure.


RESULTS
Types and content of patient work involved in living with end-stage heart failure.


RESULTS
For patients with advanced heart failure, work consisted mainly of four types of tasks, as identified by Glaser and Strauss: 'managing illness', 'everyday work to keep life going', 'biographical work' and 'arrangement work'.


CONCLUSIONS
Systematic attention to patient work, for example using these four categories, could improve the quality of care from the patient's perspective.
Willems
D L
DL
Department of General Practice, Academic Medical Centre/University of Amsterdam, The Netherlands. d.l.willems@amc.uva.nl
Hak
A
A
Visser
F C
FC
Cornel
J
J
van der Wal
G
G
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010166:Palliative Care / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life; D014937:Work / Q000523:psychology*