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美国心脏协会/美国心脏病学会分类的B期慢性心力衰竭患者未满足的姑息治疗需求

Unmet Palliative Care Needs of Patients with Stage B Chronic Heart Failure Classified by the American Heart Association/American College of Cardiology.

作者信息

Matsunuma Ryo, Yamaguchi Takashi, Matsumoto Kensuke, Sakashita Akihiro, Hashiguchi Chikako, Iida Masashi, Kizawa Yoshiyuki

机构信息

Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Department of Cardiology, Kobe University Hospital, Kobe, Japan.

出版信息

Indian J Palliat Care. 2024 Oct-Dec;30(4):384-387. doi: 10.25259/IJPC_37_2023. Epub 2024 Nov 15.

Abstract

This study sought to explore the unmet palliative care needs of patients diagnosed with Stage B chronic heart failure (CHF) according to the American Heart Association (AHA) and American College of Cardiology (ACC) classifications. We conducted this cross-sectional study between June 1 and August 31, 2020, at Kobe University Hospital. Patients were asked to complete the Integrated Palliative care Outcome Scale (IPOS) along with a customized questionnaire developed by a multidisciplinary team. These tools were filled out by the patients themselves or with help from family members. A total of 101 patients participated in the study, with 55 of them (55%) falling into the Stage B CHF group as classified by AHA/ACC. Among the physical symptoms, 22% reported dyspnea and 20% reported drowsiness as common concerns. Regarding specific problems, 47% identified issues related to exercise, 62% with eating, 26% with finances, and 18% with employment. Notably, financial difficulties were found to be significantly more common among Stage B patients when compared to those in Stages C and D (odds ratio [OR]: 5.22; 95% confidence interval [95% CI]: 1.03-26.5; p = 0.032). Almost 79% of Stage B patients expressed a desire to understand the progression of their disease. In conclusion, stage B CHF patients may face financial difficulties and have unmet informational needs. Therefore, further research is necessary to explore these aspects in greater detail.

摘要

本研究旨在根据美国心脏协会(AHA)和美国心脏病学会(ACC)的分类,探讨被诊断为B期慢性心力衰竭(CHF)患者未得到满足的姑息治疗需求。我们于2020年6月1日至8月31日在神户大学医院进行了这项横断面研究。患者被要求填写综合姑息治疗结果量表(IPOS)以及由多学科团队制定的定制问卷。这些工具由患者本人或在家庭成员的帮助下填写。共有101名患者参与了研究,其中55名(55%)属于AHA/ACC分类的B期CHF组。在身体症状方面,22%的患者报告呼吸困难,20%的患者报告嗜睡是常见问题。关于具体问题,47%的患者指出与运动有关的问题,62%与饮食有关,26%与财务有关,18%与就业有关。值得注意的是,与C期和D期患者相比,B期患者的财务困难明显更为常见(优势比[OR]:5.22;95%置信区间[95%CI]:1.03 - 26.5;p = 0.032)。近79%的B期患者表示希望了解自己疾病的进展情况。总之,B期CHF患者可能面临财务困难且有未得到满足的信息需求。因此有必要进一步研究以更详细地探讨这些方面。

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