利用患者报告结果识别心力衰竭患者的姑息治疗需求。

IF 3.2 2区 医学 Q2 CLINICAL NEUROLOGY
Camilla Lykke PhD , Birgit Jurlander MD, PhD , Ola Ekholm MSc , Per Sjøgren MD, DMSci , Gitte Irene Juhl MD, PhD , Geana Paula Kurita PhD , Sille Larsen RN , Niels Tønder MD, DMSci , Lene Vibe Høyer CNL , Inge Eidemak MD, PhD , Ann-Dorthe Zwisler MD, PhD
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引用次数: 0

摘要

背景:心力衰竭(HF)被认为是一种多方面的、危及生命的综合征,其特点是症状负担重、死亡率高:描述心力衰竭患者的症状负担并确定其姑息治疗需求。为此,我们分析了与性别、年龄和纽约心脏协会功能分类法(NYHA)中高血压分类有关的症状负担:方法:一项横断面问卷调查包括了NYHA II、III和IV级的成年高血压患者。姑息治疗需求通过有效的患者报告结果指标进行评估:SF-36v1、HeartQoL、EORTC- QLQ-C15-PAL、MFI-20 和 HADS。患者从丹麦北西兰医院心脏病科招募:共有 314 名患者(79%)完成了问卷调查(233 名男性)。平均年龄为 74 岁(35-94 岁不等)。其中 42% 的患者 NYHA III 级或 IV 级,53% 的患者自评健康状况一般或较差。根据 EORTC-QLQ-C15-PAL 标准,19% 的 NYHA II 期和 67% 的 NYHA III/IV 期患者有≥4 种严重姑息症状。此外,NYHA III/IV 平均有 8.9 个症状,平均有 5.4 个严重症状。女性、老年患者和 NYHA III/IV 患者的健康相关生活质量、功能能力和症状负担较差:结论:心房颤动患者的症状发生率较高,因此可能需要姑息治疗。主要是女性、老年患者和疾病严重程度较高的患者的症状负担最重。PROMs可帮助心脏病专家满足姑息治疗需求,系统性评估可能是整合症状缓解和姑息治疗干预措施的先决条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Identifying Palliative Care Needs in Patients With Heart Failure Using Patient Reported Outcomes

Context

Heart failure (HF) is considered a multifaceted and life-threatening syndrome characterized by high symptom-burden and significant mortality.

Objectives

To describe the symptom-burden in patients with HF and identify their palliative care needs. In this respect, symptom burden related to sex, age and classification of HF using New York Heart Association Functional Classification (NYHA) were analyzed.

Methods

A cross-sectional questionnaire survey included adult HF patients according to NYHA II, III, and IV. Palliative care needs were assessed using validated patient reported outcomes measures; SF-36v1, HeartQoL, EORTC- QLQ-C15-PAL, MFI-20 and HADS. Patients were recruited from the Department of Cardiology, North Zealand Hospital, Denmark.

Results

In total, 314 patients (79%) completed the questionnaire (233 men). Mean age = 74 years (range 35–94 years). In all, 42% had NYHA III or IV and 53% self-rated their health to be fair or poor. In all, 19% NYHA II and 67% NYHA III/IV patients had ≥4 severe palliative symptoms according to EORTC-QLQ-C15-PAL. In addition, NYHA III/IV had a mean of 8.9 symptoms and a mean of 5.4 severe symptoms. Women, older patients, and those with NYHA III/IV had worse outcomes regarding health-related quality of life, functional capacity, and symptom burden.

Conclusions

Patients with HF have a high prevalence of symptoms and, thus, potential palliative care needs. Predominantly, women, older patients, and those with higher severity of disease have the highest symptom burden. PROMs can help cardiologists address the palliative care needs and systematic assessment may be a prerequisite to integrate symptom-modifying and palliative care interventions.
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来源期刊
CiteScore
8.90
自引率
6.40%
发文量
821
审稿时长
26 days
期刊介绍: The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.
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