Brännström Margareta, Jaarsma Tiny
Strategic Research Program in Health Care Sciences (SFO-V), 'Bridging Research and Practice for Better Health', Department of Nursing, Umeå University, Umeå, Sweden.
Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Scand J Caring Sci. 2015 Jun;29(2):379-85. doi: 10.1111/scs.12174. Epub 2014 Oct 9.
Integrating heart failure and palliative care teams combines unique expertise from both cardiology and palliative care. However, professionals from the two arenas of life-saving cardiology and palliative care may well have different experiences with and approaches to patient care. Little is known how to optimally discuss cardiopulmonary resuscitation with patients and their relatives and what challenges are for healthcare providers.
The aim of this study was to describe the experiences and thoughts of members of an integrated heart failure and palliative care team concerning talking about CPR with end-stage heart failure patients.
We used a descriptive qualitative design, conducting group interviews during 2011 with professionals from different disciplines working with heart failure patients over a 1-year period. A qualitative content analysis was performed to examine the interview data.
Professional caregivers in integrated heart failure and palliative homecare are struggling with the issue of CPR of end-stage heart failure patients. They wrestle with the question of whether CPR should be performed at all in these terminally ill patients. They also feel challenged by the actual conversation about CPR with the patients and their relatives. Despite talking them about CPR with patients and relatives is difficult, the study participants described that doing so is important, as it could be the start of a broader end-of-life conversation.
Talking with patient and relatives about CPR in end-stage heart failure, as suggested in the current heart failure guidelines, is a challenge in daily clinical practice. It is important to discuss the difficulties within the team and to decide whether, whom, how and when to talk about CPR with individual patients and their relatives.
整合心力衰竭和姑息治疗团队可融合心脏病学和姑息治疗的独特专业知识。然而，来自挽救生命的心脏病学和姑息治疗这两个领域的专业人员在患者护理方面可能有不同的经验和方法。对于如何与患者及其亲属最佳地讨论心肺复苏以及医疗保健提供者面临哪些挑战，人们知之甚少。
本研究的目的是描述心力衰竭和姑息治疗综合团队成员在与终末期心力衰竭患者谈论心肺复苏方面的经验和想法。
我们采用描述性定性设计，在2011年期间对在1年时间内与心力衰竭患者合作的不同学科专业人员进行了小组访谈。对访谈数据进行了定性内容分析。
心力衰竭和姑息家庭护理综合团队中的专业护理人员在终末期心力衰竭患者的心肺复苏问题上感到困扰。他们纠结于这些绝症患者是否应该进行心肺复苏。他们也感到与患者及其亲属实际谈论心肺复苏具有挑战性。尽管与患者和亲属谈论心肺复苏很困难，但研究参与者表示这样做很重要，因为这可能是更广泛的临终谈话的开始。
按照当前心力衰竭指南的建议，在日常临床实践中，与终末期心力衰竭患者及其亲属谈论心肺复苏是一项挑战。在团队内部讨论困难之处，并决定是否、与谁、如何以及何时与个别患者及其亲属谈论心肺复苏，这很重要。
