What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study

BMC Palliative Care

Marieke H. J. van den Beuken-van Everdingen¹  Yvonne Engels²  Lisette M. van den Broek³  Hans-Peter Brunner-La Rocca⁴  Sebastiaan C. A. M. Bekkers⁴  Louise Bellersen⁵  Stephanie M. C. Ament⁶  Daisy J. A. Janssen⁷  José M. C. Maessen⁸  Josiane J. J. Boyne⁸ 

[1] Centre of Expertise for Palliative Care, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands;Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Centre, Nijmegen, the Netherlands;Department of Cardiology, Bernhoven Hospital, Uden, the Netherlands;Department of Cardiology, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands;Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands;Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands;Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands;Department of Research and Development, Ciro Horn, P.O. Box 4009, 6080 AA, Haelen, the Netherlands;Department of Patient and Care, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands;

关键词: End-of-life;    Palliative medicine;    Congestive heart failure;    Implementation;   

DOI  :  10.1186/s12904-021-00896-y

来源: Springer

【 摘 要 】

BackgroundNeeds assessment tools can facilitate healthcare professionals in timely recognition of palliative care needs. Despite the increased attention for implementation of such tools, most studies provide little or no attention to the context of implementation. The aim of this study was to explore factors that contribute positively and negatively to timely screening of palliative care needs in advanced chronic heart failure.MethodsQualitative study using individual interviews and focus groups with healthcare professionals. The data were analysed using a deductive approach. The Consolidated Framework for Implementation Research was used to conceptualise the contextual factors.ResultsTwenty nine healthcare professionals with different backgrounds and working in heart failure care in the Southern and Eastern parts of the Netherlands participated. Several factors were perceived to play a role, such as perception and knowledge about palliative care, awareness of palliative care needs in advanced chronic heart failure, perceived difficulty when and how to start palliative care, limited acceptance to treatment boundaries in cardiology, limited communication and collaboration between healthcare professionals, and need for education and increased attention for palliative care in advanced chronic heart failure guidelines.ConclusionsThis study clarified critical factors targeting patients, healthcare professionals, organisations to implement a needs assessment tool for timely recognition of palliative care needs in the context of advanced chronic heart failure. A multifaceted implementation strategy is needed which has attention for education, patient empowerment, interdisciplinary collaboration, identification of local champions, chronic heart failure specific guidelines and culture.

【 授权许可】

CC BY