title: Thoughts about death and perceived health status in elderly patients with heart failure.
abstract: OBJECTIVE
  To explore thoughts about death and perceived health status in elderly patients with heart failure during a 6 month period after a deterioration needing hospitalisation.
  
  
  METHODS
  A descriptive, mixed methods design was used. Health was measured with EuroQol-5D, thoughts about death with multiple choice and open questions. A total of 145 patients with New York Heart Association class II-IV heart failure, mean age 70 years, 70% males, were included.
  
  
  RESULTS
  During deterioration, 16% of the patients were afraid of dying and 4% had this fear very often. Fear of death did not change significantly during the 6 months after deterioration. Both during deterioration (r=0.26, P<0.01) and 6 months later (r=0.40, P<0.001), fear of death and anxiety/depression were correlated. Content analysis of the open question produced 5 categories: (1) Death as a natural part of life; (2) Death as a relief from symptoms and disability (3) Death as fearful (4) Arrangements for time after death (5) A wish for an extended life.
  
  
  CONCLUSIONS
  Elderly patients with heart failure had a lot of thoughts about death. Higher levels of anxiety/depression were correlated to fear of death. Many expressed death as a natural relief from suffering, others were afraid of pain, loss of independence and dignity.
authors.affiliation: Department of Medicine and Health Sciences, Division of Nursing, Linköping University, Sweden. annst@imv.liu.se <annst@imv.liu.se>
authors.forename: Anna
authors.initials: A
authors.lastname: Strömberg
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D001294:Attitude to Health; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006333:Heart Failure / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D012649:Self Concept; D011795:Surveys and Questionnaires