title: Managing palliative care for adults with advanced heart failure.
abstract: The purpose of this study was to explore the care processes experienced by community-dwelling adults dying from advanced heart failure, their family caregivers, and their health-care providers. A descriptive qualitative design was used to guide data collection, analysis, and interpretation. The sample comprised 8 patients, 10 informal caregivers, 11 nurses, 3 physicians, and 3 pharmacists. Data analysis revealed that palliative care was influenced by unique contextual factors (i.e., cancer model of palliative care, limited access to resources, prognostication challenges). Patients described choosing interventions and living with fatigue, pain, shortness of breath, and functional decline. Family caregivers described surviving caregiver burden and drawing on their faith. Health professionals described their role as trying to coordinate care, building expertise, managing medications, and optimizing interprofessional collaboration. Participants strove towards 3 outcomes: effective symptom management, satisfaction with care, and a peaceful death.
authors: School of Nursing, Division of Palliative Care, Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
authors: Sharon
authors: S
authors: Kaasalainen
authors: Patricia H
authors: PH
authors: Strachan
authors: Kevin
authors: K
authors: Brazil
authors: Denise
authors: D
authors: Marshall
authors: Kathleen
authors: K
authors: Willison
authors: Lisa
authors: L
authors: Dolovich
authors: Alan
authors: A
authors: Taniguchi
authors: Catherine
authors: C
authors: Demers
mesh_terms: D000328:Adult; D006297:Health Services Accessibility; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D010166:Palliative Care; D010348:Patient Care Team