School of Cardiovascular Medicine and Sciences, King's College London, London, UK.
Department of Palliative Care and Rehabilitation, Cicely Saunders Institute, King's College London, London, UK.
Vasc Health Risk Manag. 2024 Mar 12;20:109-123. doi: 10.2147/VHRM.S392636. eCollection 2024.
Heart failure is a commonly encountered clinical syndrome arising from a range of etiologic cardiovascular diseases and manifests in a phenotypic spectrum of varying degrees of systolic and diastolic ventricular dysfunction. Those affected by this life-limiting illness are subject to an array of burdensome symptoms, poor quality of life, prognostic uncertainty, and a relatively onerous and increasingly complex treatment regimen. This condition occurs in epidemic proportions worldwide, and given the demographic trend in societal ageing, the prevalence of heart failure is only likely to increase. The marked upturn in international migration has generated other demographic changes in recent years, and it is evident that we are living and working in ever more ethnically and culturally diverse communities. Professionals treating those with heart failure are now dealing with a much more culturally disparate clinical cohort. Given that the heart failure disease trajectory is unique to each individual, these clinicians need to ensure that their proposed treatment options and responses to the inevitable crises intrinsic to this condition are in keeping with the culturally determined values, preferences, and worldviews of these patients and their families. In this narrative review, we describe the importance of cultural awareness across a range of themes relevant to heart failure management and emphasize the centrality of cultural competence as the basis of appropriate care provision.
心力衰竭是一种常见的临床综合征,由多种病因的心血管疾病引起,表现为不同程度的收缩和舒张心室功能障碍的表型谱。患有这种危及生命的疾病的人会承受一系列负担沉重的症状、生活质量差、预后不确定以及相对繁重和日益复杂的治疗方案。这种情况在全球范围内普遍存在,而且由于社会老龄化的人口趋势,心力衰竭的患病率只会增加。近年来,国际移民的显著增加带来了其他人口变化,显然我们生活和工作的社区越来越多样化。治疗心力衰竭患者的专业人员现在正在处理一个文化差异更大的临床群体。鉴于心力衰竭的疾病轨迹因人而异,这些临床医生需要确保他们提出的治疗方案和对这种疾病固有的不可避免危机的反应符合这些患者及其家人的文化决定的价值观、偏好和世界观。在这篇叙述性评论中,我们描述了在与心力衰竭管理相关的一系列主题中文化意识的重要性,并强调文化能力作为提供适当护理的基础的核心地位。