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Contra A, Garcia L, Pons P, Formiga F. [Do patients with advanced heart failure know the characteristics and prognosis of their disease?]. Rev Esp Geriatr Gerontol 2024; 59:101456. [PMID: 38245994 DOI: 10.1016/j.regg.2023.101456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/10/2023] [Indexed: 01/23/2024]
Affiliation(s)
- Anna Contra
- Servicio de Medicina Interna. Hospital Universitari de Bellvitge. IDIBELL. Universidad de Barcelona. L'Hospitalet de Llobregat, Barcelona, España.
| | - Lourdes Garcia
- Servicio de Medicina Interna. Hospital Universitari de Bellvitge. IDIBELL. Universidad de Barcelona. L'Hospitalet de Llobregat, Barcelona, España
| | - Paula Pons
- Servicio de Medicina Interna. Hospital Universitari de Bellvitge. IDIBELL. Universidad de Barcelona. L'Hospitalet de Llobregat, Barcelona, España
| | - Francesc Formiga
- Servicio de Medicina Interna. Hospital Universitari de Bellvitge. IDIBELL. Universidad de Barcelona. L'Hospitalet de Llobregat, Barcelona, España
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Llop-Medina L, García-Muñoz P, Ródenas-Rigla F, Garcés-Ferrer J. Enhancing the Adult and Paediatric Palliative Care System: Spanish Professionals' and Family Caregivers' Suggestions for Comprehensive Improvement. Healthcare (Basel) 2023; 12:65. [PMID: 38200971 PMCID: PMC10779096 DOI: 10.3390/healthcare12010065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/21/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024] Open
Abstract
This research critically explores deficiencies in the palliative care system, focusing on evaluation and treatment aspects for both adult and paediatric patients. Using a qualitative methodology, the study engages healthcare professionals and family caregivers to uncover perspectives on the existing state of palliative care. Conducted through three focus groups and a semi-structured in-depth interview with participants recruited from Virgen de la Arrixaca University Clinical Hospital, this research illustrates critical issues, highlighting the insufficient healthcare workforce and resources to meet the comprehensive needs of patients and their families. Recommendations include holistic care addressing social, emotional, psychological, socio-familiar, and economic dimensions, supported by embedded support groups and the enforcement of relationships with palliative associations. This study also advocates for improved health institutional coordination, social worker support, and ongoing health professional satisfaction monitoring. In paediatric care, specific demands involve specialised units, medical team continuity, 24 h paediatrician care, and a more professional paediatric approach. Beyond problem identification, this study offers valuable insights for shaping health policies and tools, incorporating new indicators and introducing grief bereavement support in clinical reports, contributing to the advancement of patient evaluation in palliative care.
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Affiliation(s)
- Laura Llop-Medina
- Polibienestar Research Institute, University of Valencia, 46022 Valencia, Spain; (P.G.-M.); (F.R.-R.); (J.G.-F.)
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Aguilar-Fuerte M, Alonso-Ecenarro F, Broch-Petit A, Chover-Sierra E. Palliative Care Needs and Clinical Features Related to Short-Term Mortality in Patients Enrolled in a Heart Failure Unit. Healthcare (Basel) 2022; 10:healthcare10091609. [PMID: 36141221 PMCID: PMC9498741 DOI: 10.3390/healthcare10091609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 01/08/2023] Open
Abstract
(1) Background: Heart failure (HF) is a chronic and complex pathology requiring continuous patient management due to clinical instability, associated comorbidity, and extensive pharmacological treatment. Its unpredictable course makes the advanced stages challenging to recognize and raises the need for palliative care. This study aims to identify palliative care needs in HF patients and describe clinical features related to short-term mortality. (2) Methods: A descriptive, observational, cross-sectional, and retrospective study was carried out in an HF unit of a Spanish tertiary hospital. Patients’ socio-demographic and clinical data were collected from clinical records, and different instruments were used to establish mortality risks and patients’ needs for palliative care. Subsequently, univariate and bivariate descriptive analyses were performed. A binary logistic regression model helped to determine variables that could influence mortality 12 months after admission to the Unit. (3) Results: The studied population, sixty-five percent women, had an average age of 83.27 years. Among other clinical characteristics predominated preserved ejection fraction (pEF) and dyspnea NYHA (New York Heart Association) class II. The most prevalent comorbidities were hypertension and coronary heart disease. Forty-nine percent had a low–intermediate mortality risk in the following year, according to the PROFUND index. The NECPAL CCOMS-ICO© instrument identified subjects who meet the criteria for palliative care. This predictive model identified NECPAL CCOMS-ICO© results, using beta-blockers (BB) or AIIRA (Angiotensin II receptor antagonists) and low glomerular filtration rate (GFR) as explanatory variables of patients’ mortality in the following year. (4) Conclusions: The analysis of the characteristics of the population with HF allows us to identify patients in need of palliative care. The NECPAL CCOMS-ICO© instrument and the PROFUND have helped identify the characteristics of people with HF who would benefit from palliative management.
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Affiliation(s)
- Marta Aguilar-Fuerte
- Nursing Department, Facultat d’Infermeria i Podologia, Universitat de València, 46010 València, Spain
| | | | - Alejandro Broch-Petit
- Internal Medicine, Consorcio Hospital General Universitario de Valencia, 46014 València, Spain
| | - Elena Chover-Sierra
- Nursing Department, Facultat d’Infermeria i Podologia, Universitat de València, 46010 València, Spain
- Internal Medicine, Consorcio Hospital General Universitario de Valencia, 46014 València, Spain
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 València, Spain
- Correspondence:
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García Pinilla JM, Díez-Villanueva P, Bover Freire R, Formiga F, Cobo Marcos M, Bonanad C, Crespo Leiro MG, Ruiz García J, Díaz Molina B, Enjuanes Grau C, García L, Rexach L, Esteban A, Martínez-Sellés M. Documento de consenso y recomendaciones sobre cuidados paliativos en insuficiencia cardiaca de las Secciones de Insuficiencia Cardiaca y Cardiología Geriátrica de la Sociedad Española de Cardiología. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2019.06.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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García Pinilla JM, Díez-Villanueva P, Bover Freire R, Formiga F, Cobo Marcos M, Bonanad C, Crespo Leiro MG, Ruiz García J, Díaz Molina B, Enjuanes Grau C, García L, Rexach L, Esteban A, Martínez-Sellés M. Consensus document and recommendations on palliative care in heart failure of the Heart Failure and Geriatric Cardiology Working Groups of the Spanish Society of Cardiology. ACTA ACUST UNITED AC 2019; 73:69-77. [PMID: 31761573 DOI: 10.1016/j.rec.2019.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 06/05/2019] [Indexed: 12/21/2022]
Abstract
Heart failure is a complex entity, with high morbidity and mortality. The clinical course and outcome are uncertain and difficult to predict. This document, instigated by the Heart Failure and Geriatric Cardiology Working Groups of the Spanish Society of Cardiology, addresses various aspects related to palliative care, where most cardiovascular disease will eventually converge. The document also establishes a consensus and a series of recommendations with the aim of recognizing and understanding the need to implement and progressively apply palliative care throughout the course of the disease, not only in the advanced stages, thus improving the care provided and quality of life. The purpose is to improve and adapt treatment to the needs and wishes of each patient, who must have adequate information and participate in decision-making.
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Affiliation(s)
- José Manuel García Pinilla
- Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Ramón Bover Freire
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Cardiología, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Francesc Formiga
- Programa de Geriatría, Servicio de Medicina Interna, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Marta Cobo Marcos
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Clara Bonanad
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - María G Crespo Leiro
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - Juan Ruiz García
- Servicio de Cardiología, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
| | - Beatriz Díaz Molina
- Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Cristina Enjuanes Grau
- Servicio de Cardiología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Lluisa García
- Servicio de Cardiología, Hospital Universitario Dr. Josep Trueta, Girona, Spain
| | - Lourdes Rexach
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Alberto Esteban
- Servicio de Cardiología, Hospital Universitario de Móstoles, Madrid, Spain
| | - Manuel Martínez-Sellés
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Gregorio Marañón, Madrid, Spain
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