Understanding and Defining Palliative Care in Chronic Heart Failure: A Survey of Cardiovascular Health Professionals

Background: Individuals with chronic heart failure experience high symptom burden, and poor quality of life. Palliative care is recommended in best practice guidelines; however, barriers currently exist, including health professionals’ understanding of palliative care.Aims: To determine how Australian and New Zealand cardiovascular healthcare professionals understand and define palliative care.Methods: An electronic survey was emailed to members of four peak bodies and professional networks involved in chronic heart failure care. Social media recruitment was also utilised. Paper-based versions were completed by attendees of the 66th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, August 2018. Participants were asked to describe their understanding and definition of palliative care in an open-ended question. Manifest content analysis was used to count the frequency of key words.Results: There were 101 completed responses. Participants were mostly female (n=83) and were nurses (n=73), physicians (n=24) or allied health professionals (n=4). The majority (n=78) had more than 20 years of clinical practice. Participants described palliative care as mainly encompassing symptom management (n=50), relating to end of life or dying (n=45). Participants described palliative care as providing support and comfort (n=41) to improve quality of life (n=29). The domains of palliative care were mentioned (n=19) and viewed as holistic care (n=13).Conclusion: Cardiovascular health professionals’ view of palliative care as end of life or dying can influence timely palliative care that extends beyond symptom management. Interdisciplinary education and new models of care are needed to improve palliative care for patients with chronic heart failure