Gerlich Miriam G, Klindtworth Katharina, Oster Peter, Pfisterer Mathias, Hager Klaus, Schneider Nils
Hannover Medical School, Institute for Epidemiology, Social Medicine and Health Systems Research, Research Group Palliative Care and Ageing, Hannover, Germany.
Agaplesion Bethanien Hospital, Geriatric Centre at the University, Heidelberg, Germany.
Eur J Ageing. 2012 Sep 22;9(4):297-303. doi: 10.1007/s10433-012-0244-6. eCollection 2012 Dec.
Heart failure is a leading cause of death and can result in significant palliative care needs. The aim of this study was to explore the needs of older patients with advanced heart failure, and their experiences with health care delivery in Germany. Qualitative interviews were carried out with 12 patients (6 men, 6 women; age 73-94 years; heart failure in an advanced stage according to the New York Heart Association Functional Classification) recruited in two geriatric hospitals. The interviews were analyzed by a qualitative descriptive approach. The main categories derived from the patient interviews were: understanding of illness and prognosis, health care services and social life. The patients expressed the need for better information and communication regarding illness and prognosis, and the desire for more respectful treatment by health care providers. Heart failure was not recognized as a potentially life-limiting disease, and the patients had no experience with palliative care services. The study emphasizes the need for improving communication with patients with advanced heart failure. To achieve this, strengthening the palliative care approach in all relevant services that deliver care for these patients and introducing advanced care planning appear to be promising strategies.
心力衰竭是主要死因之一，并会导致大量姑息治疗需求。本研究旨在探讨老年晚期心力衰竭患者的需求，以及他们在德国接受医疗服务的体验。在两家老年医院招募了12名患者（6名男性，6名女性；年龄73 - 94岁；根据纽约心脏协会功能分级处于晚期心力衰竭阶段）进行定性访谈。采用定性描述方法对访谈进行分析。从患者访谈中得出的主要类别为：对疾病和预后的理解、医疗服务及社会生活。患者表示需要就疾病和预后获得更好的信息与沟通，并希望医疗服务提供者给予更尊重的治疗。心力衰竭未被视为一种可能危及生命的疾病，患者也没有接受过姑息治疗服务的经历。该研究强调了改善与晚期心力衰竭患者沟通的必要性。为实现这一点，在为这些患者提供护理的所有相关服务中加强姑息治疗方法并引入晚期护理计划似乎是很有前景的策略。
