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Symptoms and fear in heart failure patients approaching end of life: a mixed methods study

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Listed:
  • Martha Abshire
  • Jiayun Xu
  • Cheryl Dennison Himmelfarb
  • Patricia Davidson
  • Daniel Sulmasy
  • Joan Kub
  • Mark Hughes
  • Marie Nolan

Abstract

Aims and Objectives The purpose of this study was to consider how fear and symptom experience are perceived in patients with heart failure at the end of life. Background Heart failure is a burdensome condition and mortality rates are high globally. There is substantive literature describing suffering and unmet needs but description of the experience of fear and the relationship with symptom burden is limited. Design A convergent mixed methods design was used. Methods Data from the McGill Quality of Life Questionnaire (n = 55) were compared to data from in‐depth interviews (n = 5). Results Patients denied fear when asked directly, but frequently referred to moments of being afraid when they were experiencing symptoms. In addition, patients reported few troublesome symptoms on the survey, but mentioned many more symptoms during interviews. Conclusions These data not only identify the relationship between psychological issues and symptom experience but also elucidate the benefit of a mixed method approach in describing such experiences from the perspective of the patient. Future research should examine relationships between and among symptom experience, fear and other psychological constructs across the illness trajectory. Relevance to Clinical Practice Conversations about the interaction of symptom burden and fear can lead to both a more robust assessment of symptoms and lead to patient centred interventions.

Suggested Citation

  • Martha Abshire & Jiayun Xu & Cheryl Dennison Himmelfarb & Patricia Davidson & Daniel Sulmasy & Joan Kub & Mark Hughes & Marie Nolan, 2015. "Symptoms and fear in heart failure patients approaching end of life: a mixed methods study," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(21-22), pages 3215-3223, November.
  • Handle: RePEc:wly:jocnur:v:24:y:2015:i:21-22:p:3215-3223
    DOI: 10.1111/jocn.12973
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    Cited by:

    1. Parvin Mangolian Shahrbabaki & Esmat Nouhi & Majid Kazemi & Fazlollah Ahmadi, 2017. "The sliding context of health: the challenges faced by patients with heart failure from the perspective of patients, healthcare providers and family members," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(21-22), pages 3597-3609, November.
    2. Seyede Fatemeh Gheiasi & Mohammad Ali Cheraghi & Mahdieh Dastjerdi & Hossein Navid & Meysam Khoshavi & Hamid Peyrovi & Alice Khachian & Khatereh Seylani & Maryam Esmaeili & Elham Navab, 2023. "Experiences of Facilitators and Inhibitors to Treatment Adherence in Patients with Heart Failure," Clinical Nursing Research, , vol. 32(3), pages 648-659, March.
    3. Bettina Højberg Kirk & Ole De Backer & Malene Missel, 2019. "Transforming the experience of aortic valve disease in older patients: A qualitative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(7-8), pages 1233-1241, April.

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