title: Symptom burden, depression, and spiritual well-being: a comparison of heart failure and advanced cancer patients.
abstract: BACKGROUND
  A lower proportion of patients with chronic heart failure receive palliative care compared to patients with advanced cancer.
  
  
  OBJECTIVE
  We examined the relative need for palliative care in the two conditions by comparing symptom burden, psychological well-being, and spiritual well-being in heart failure and cancer patients.
  
  
  METHODS
  This was a cross-sectional study.
  
  
  METHODS
  Sixty outpatients with symptomatic heart failure and 30 outpatients with advanced lung or pancreatic cancer.
  
  
  METHODS
  Symptom burden (Memorial Symptom Assessment Scale-Short Form), depression symptoms (Geriatric Depression Scale-Short Form), and spiritual well-being (Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being scale).
  
  
  RESULTS
  Overall, the heart failure patients and the cancer patients had similar numbers of physical symptoms (9.1 vs. 8.6, p = 0.79), depression scores (3.9 vs. 3.2, p = 0.53), and spiritual well-being (35.9 vs. 39.0, p = 0.31) after adjustment for age, gender, marital status, education, and income. Symptom burden, depression symptoms, and spiritual well-being were also similar among heart failure patients with ejection fraction < or =30, ejection fraction >30, and cancer patients. Heart failure patients with worse heart failure-related health status had a greater number of physical symptoms (13.2 vs. 8.6, p = 0.03), higher depression scores (6.7 vs. 3.2, p = 0.001), and lower spiritual well-being (29.0 vs. 38.9, p < 0.01) than patients with advanced cancer.
  
  
  CONCLUSIONS
  Patients with symptomatic heart failure and advanced cancer have similar needs for palliative care as assessed by symptom burden, depression, and spiritual well-being. This implies that heart failure patients, particularly those with more severe heart failure, need the option of palliative care just as cancer patients do.
authors.affiliation: Department of Medicine, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA. David.Bekelman@ucdenver.edu
authors.forename: David B
authors.initials: DB
authors.lastname: Bekelman
authors.forename: John S
authors.initials: JS
authors.lastname: Rumsfeld
authors.forename: Edward P
authors.initials: EP
authors.lastname: Havranek
authors.forename: Traci E
authors.initials: TE
authors.lastname: Yamashita
authors.forename: Evelyn
authors.initials: E
authors.lastname: Hutt
authors.forename: Sheldon H
authors.initials: SH
authors.lastname: Gottlieb
authors.forename: Sydney M
authors.initials: SM
authors.lastname: Dy
authors.forename: Jean S
authors.initials: JS
authors.lastname: Kutner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000473:pathology / Q000523:psychology*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000473:pathology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000473:pathology / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D029181:Spirituality