[Palliative care needs of heart failure patients: A mixed-method studyNecessidades de cuidados paliativos de pacientes com insuficiencia cardíaca: um estudo misto].

Introduction: The presence of physical, psychosocial, and spiritual signs and symptoms should be identified and managed through the palliative care that health care teams and professionals pro vide.

Objective: To identify the palliative care needs of people with heart failure, their caregivers, and the multidisciplinary team of a heart failure unit.

Materials and methods: A mixed-method study with a sequential transformative design (DITRAS, for its acronym in Spanish) was conducted. It began with a quantitative phase in which the Edmonton Symptom Assessment Scale (ESAS), the Therapy-Spiritual Well-Being Scale (FACIT-Sp-12), and the Barthel Index were used. The qualitative phase was conducted with three focus groups involving seven patients, eight caregivers, and twelve health professionals from the multidisciplinary team. Elizabeth Lenz's Theory of Unpleasant Symptoms was used as a guideline for this study.

Results: Physiological (edema, fatigue, and dyspnea) and psychological (attitude towards life and enjoyment of hobbies) palliative care needs and situational factors (caregiver dependence and support networks) were identified and could be understood through Lenz's theory.

Conclusions: Palliative care needs in patients with heart failure are presented under a framework of symptoms that patients, caregivers, and the health care team perceive. Comprehensive approaches are required to improve symptom experience.