Singh Gursharan K, Davidson Patricia M, Macdonald Peter S, Newton Phillip J
School of Nursing and Midwifery, Western Sydney University, Sydney, NSW, Australia.
School of Nursing, Johns Hopkins University, Baltimore, MD, USA.
Heart Lung Circ. 2019 Apr;28(4):539-552. doi: 10.1016/j.hlc.2018.10.009. Epub 2018 Oct 17.
Chronic heart failure is a complex and multifaceted syndrome characterised by an unpredictable trajectory, high symptom burden and reduced quality of life. Although palliative care is recommended, patient, provider and system factors limit access.
To examine the knowledge, attitudes and perspectives of health care professionals towards end of life care and palliative care for patients with chronic heart failure.
This is an integrative review.
CINAHL, Academic Search Complete and SCOPUS were searched. Specific inclusion criteria and search terms were used. The integrative review method entailed analysing data from primary articles using the constant comparison method and then synthesising data.
Twenty-six (26) articles were selected that explored health care professionals' perspectives towards end of life care and palliative care. The categories that emerged were grouped into patient, provider and system issues. Most health care professionals involved in providing care to heart failure patients have misperceptions of palliative care, often confusing it with end of life and hospice care. This hinders patients' access to palliative care as determining the end of life period in heart failure is difficult.
Exploring health care professionals' perspectives towards the delivery of end of life care and palliative care is important for understanding how their practice influences the delivery of palliative care for heart failure patients. Emphasis on increasing awareness of the principles of palliative care in the health care community, as well as addressing organisational issues will improve the care delivered to these patients.
慢性心力衰竭是一种复杂且多方面的综合征，其特点是病程难以预测、症状负担重且生活质量下降。尽管推荐采用姑息治疗，但患者、医疗服务提供者及系统因素限制了其可及性。
探讨医护人员对慢性心力衰竭患者临终关怀和姑息治疗的知识、态度及观点。
这是一项整合性综述。
检索了护理学与健康领域数据库（CINAHL）、学术搜索完整版和Scopus数据库。使用了特定的纳入标准和检索词。整合性综述方法包括使用持续比较法分析原始文章中的数据，然后对数据进行综合。
选取了26篇探讨医护人员对临终关怀和姑息治疗观点的文章。出现的类别分为患者、医疗服务提供者和系统问题。大多数参与为心力衰竭患者提供护理的医护人员对姑息治疗存在误解，常常将其与临终关怀和临终安养院护理相混淆。这阻碍了患者获得姑息治疗，因为确定心力衰竭患者的临终阶段很困难。
探讨医护人员对临终关怀和姑息治疗的观点，对于理解他们的实践如何影响心力衰竭患者的姑息治疗提供很重要。强调提高医疗保健社区对姑息治疗原则的认识，以及解决组织问题，将改善对这些患者的护理。
