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Open Access Managing Palliative Care for Adults With Advanced Heart Failure La gestion des soins palliatifs prodigués aux adultes atteints d'insuffisance cardiaque à un stade avancé

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Abstract:

The purpose of this study was to explore the care processes experienced by community-dwelling adults dying from advanced heart failure, their family caregivers, and their health-care providers. A descriptive qualitative design was used to guide data collection, analysis, and interpretation. The sample comprised 8 patients, 10 informal caregivers, 11 nurses, 3 physicians, and 3 pharmacists. Data analysis revealed that palliative care was influenced by unique contextual factors (i.e., cancer model of palliative care, limited access to resources, prognostication challenges). Patients described choosing interventions and living with fatigue, pain, shortness of breath, and functional decline. Family caregivers described surviving caregiver burden and drawing on their faith. Health professionals described their role as trying to coordinate care, building expertise, managing medications, and optimizing interprofessional collaboration. Participants strove towards 3 outcomes: effective symptom management, satisfaction with care, and a peaceful death.

French
Notre étude visait à étudier le déroulement de la prestation des soins prodigués à des adultes résidant dans la communauté, mourant d'insuffisance cardiaque à un stade avancé, à la lumière de l'expérience des patients, des proches aidants et des prestataires de soins. Un plan d'analyse descriptive et qualitative a servi à guider la collecte, l'analyse et l'interprétation des données. L'échantillon comportait 8 patients, 10 proches aidants, 11 infirmières, 3 médecins et 3 pharmaciens. L'analyse des données révèle que certains facteurs contextuels particuliers influent sur la prestation des soins palliatifs (soit le modèle de soins palliatifs en matière de cancer, l'accès limité aux ressources et les difficultés relatives à la pronostication). Les patients ont décrit le choix des interventions et le fait de composer avec la fatigue, la douleur, la dyspnée et la perte d'autonomie. Les proches aidants ont parlé de surmonter le fardeau de la prestation des soins et de la foi qui les soutenait. Les professionnels de la santé ont décrit leur rôle relativement à la coordination des soins, au transfert de compétences, à la gestion des médicaments et à l'optimisation de la collaboration interprofessionnelle. Les participants aspiraient à atteindre trois résultats : la gestion efficace des symptômes; la satisfaction à l'égard des soins; et une mort paisible.

Keywords: ACCESS TO CARE; CARDIOVASCULAR DISEASE; COMMUNITY HEALTH NURSING; PALLIATIVE CARE

Document Type: Research Article

Publication date: 2011-09-01

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