An Investigation of the Benefits of Palliative Care for Patients with Chronic Heart Failure at a Novel Hospital-Based Palliative Care Service.

Master Thesis


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University of Cape Town

INTRODUCTION: Heart failure is a chronic cardiac condition that would benefit from palliative care and yet palliative care is still mainly provided for people with cancer or HIV. Patients with end-stage heart failure experience similar clinical symptoms as patients with advanced cancer with significant physical and emotional suffering. This research study investigated and assessed the benefits of palliative care in this vulnerable population at a district hospital in Cape Town and emphasized the importance of a hospital-based palliative care facility. METHODOLOGY: A cross-sectional descriptive qualitative study was conducted with in-depth interviews of people living with heart failure using thematic analysis of patient interviews. The study was conducted at a palliative care facility at a government district hospital. Purposive sampling was used for patient selection. A total of 12 participants were interviewed until data saturation. RESULTS: The mean age of the 7 men and 5 women interviewed was 52 years, the youngest participant was aged 27 years old and the eldest was 78. Analysis of these 12 semi- structured interviews produced five main themes. The first theme that emerged focused on issues of high service usage due to recurrent hospitalizations in the group, the second on communication factors in palliative care. The third theme was on information and education, the fourth on the importance of resources in palliative care and the last theme was on the Abundant Life Palliative Care Programme. DISCUSSION: Findings from this study supports the importance of palliative care for people with heart failure. Palliative care early in the disease aims to improve the quality of life for such patients and their families. The data supports the fact that early referral for palliative care resulted in greater symptom control and benefit to the patient long before hospice care is needed. Previous studies have also proven to reduce re-hospitalization rates of this population while reducing costs to the healthcare system.