Singh Gursharan K, Ferguson Caleb, Davidson Patricia M, Newton Phillip J
School of Nursing & Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
Western Sydney Local Health District, Blacktown Hospital, Blacktown, NSW 2148, Australia.
Contemp Nurse. 2021 Feb-Apr;57(1-2):113-127. doi: 10.1080/10376178.2021.1928522. Epub 2021 May 28.
Heart failure is a chronic condition with various implications for individuals and families. Although the importance of implementing palliative care is recommended in best practice guidelines, implementation strategies are less clear.
This study sought to; (1) determine Australian and New Zealand cardiovascular nurses and physicians' end of life care attitudes and specialist palliative care referral in heart failure and; (2) determine self-reported delivery of supportive care and attitudes towards service names.
An electronic survey was emailed to members of four peak bodies and professional networks. Participants were also recruited through social media. Paper-based versions of the survey were completed by attendees of the 66th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, August 2018.
There were 113 completed responses included in the analyses. Participants were nurses ( = 75), physicians ( = 32) and allied health professionals ( = 4). Most (67%) reported they were comfortable with providing end of life care; however, fewer respondents agreed they received support for their dying patients and one-third experienced a sense of failure when heart failure progressed. Most (84-100%) participants agreed they would refer a heart failure patient later in the illness trajectory. There was a more favourable attitude towards the service name 'supportive care' than to 'palliative care'.
Comfort with end of life discussions is encouraging as it may lead to a greater likelihood of planning future care and identifying palliative care needs. Peer support and supervision may be useful for addressing feelings of failure. The use of needs-based assessment tools, adopting the service name 'supportive care' and further research focusing on primary palliative team-based approach is required to improve palliative care access.
Cardiovascular nurses and physicians are comfortable providing end of life care, but referrals to palliative care in the later stages of heart failure persists.
心力衰竭是一种慢性病，对个人和家庭有多种影响。尽管最佳实践指南推荐实施姑息治疗的重要性，但其实施策略尚不明晰。
本研究旨在；（1）确定澳大利亚和新西兰心血管护士及医生对心力衰竭患者临终关怀的态度以及专科姑息治疗转诊情况；（2）确定自我报告的支持性护理提供情况以及对服务名称的态度。
通过电子邮件向四个主要团体和专业网络的成员发送电子调查问卷。还通过社交媒体招募参与者。2018年8月澳大利亚和新西兰心脏病学会第66届年度科学会议的与会者完成了纸质版调查问卷。
分析纳入了113份完整回复。参与者包括护士（n = 75）、医生（n = 32）和专职医疗人员（n = 4）。大多数（67%）报告称他们对提供临终关怀感到自在；然而，较少的受访者同意他们为临终患者提供了支持，并且三分之一的人在心力衰竭进展时感到挫败。大多数（84 - 100%）参与者同意他们会在疾病进程后期转诊心力衰竭患者。对“支持性护理”服务名称的态度比对“姑息治疗”更积极。
对临终讨论感到自在令人鼓舞，因为这可能会增加规划未来护理和确定姑息治疗需求的可能性。同伴支持和监督可能有助于解决挫败感。需要使用基于需求的评估工具，采用“支持性护理”服务名称，并进一步开展以姑息治疗初级团队为基础的研究，以改善姑息治疗的可及性。
心血管护士和医生对提供临终关怀感到自在，但在心力衰竭后期转诊至姑息治疗的情况仍然存在。
