Signs and symptoms of patients with heart failure in palliative care: scoping review
Señales y síntomas de pacientes con insuficiencia cardíaca en cuidados paliativos: revisión de alcance
Sinais e sintomas de pacientes com insuficiência cardíaca em cuidados paliativos: revisão de escopo
Paola Pugian Jardim; Ana Carla Dantas Cavalcanti; Alyne Santos Borges; Paula Vanessa Peclat Flores; Camila Achão Rosa
Abstract
Objective: To map the knowledge production on signs and symptoms of patients with heart failure in palliative care.
Method: This is a scoping review conducted according to the JBI method. Its writing was guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. The search was carried out by two independent reviewers in reference databases, information, and gray literature portals mostly using the descriptors “heart failure,” “signs and symptoms,” and “palliative care,” with the Boolean operator “and,” in September 2021 without a time frame.
Results: Thirty-four articles were included and published between 2001 and 2021 from national and international journals, 21 of which were carried out in the United States of America. These articles made it possible to map 93 signs and symptoms, including pain, dyspnea, fatigue, nausea, and depression — the most frequent ones.
Conclusion and Implications for the practice: This scoping review produced a scientific production map about the signs and symptoms of heart failure in palliative care. The knowledge of signs and symptoms helps health care professionals develop techniques and technologies to assess the severity of heart failure, plan palliative interventions, and assess their results.
Keywords
Resumen
Palabras clave
Resumo
Objetivo: Mapear a produção de conhecimento acerca dos sinais e sintomas de pacientes com insuficiência cardíaca em cuidados paliativos.
Método: Revisão de escopo conduzida de acordo com a metodologia JBI e com a redação guiada pelo Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. A busca foi realizada em setembro de 2021 por dois revisores independentes nas bases de dados referenciais e em portais de informação e de literatura cinzenta, utilizando majoritariamente os descritores “heart failure”, “signs and symptoms” e “palliative care”, com o operador booleano “and”, sem recorte temporal.
Resultados: Foram incluídos 34 artigos publicados entre 2001 e 2021, provenientes de revistas nacionais e internacionais, sendo 21 publicados nos Estados Unidos da América. Por meio desses artigos, foi possível mapear 93 sinais e sintomas, sendo que os mais frequentes foram dor, dispneia, fadiga, náusea e depressão.
Conclusão Implicações para a prática: esta revisão de escopo produziu um mapa da produção científica sobre os sinais e sintomas de insuficiência cardíaca em cuidados paliativos. O conhecimento dos sinais e sintomas auxilia os profissionais da saúde no desenvolvimento de técnicas e tecnologias para avaliar a severidade da insuficiência cardíaca, planejar intervenções paliativas e avaliar os seus resultados.
Palavras-chave
Referências
1 Mesquita ET, Jorge AJL, Rabelo LM, Souza Jr CV. Understanding hospitalization in patients with heart failure. Int J Cardiovasc Sci. 2017;30(1):81-90.
2 Rohde LEP, Montera MW, Bocchi EA, Clausell NO, Albuquerque DCD, Rassi S et al.; Comitê Coordenador da Diretriz de Insuficiência Cardíaca. Diretriz brasileira de insuficiência cardíaca crônica e aguda. Arq Bras Cardiol. 2018;111(3):436-539.
3 Ministério da Saúde (BR), Secretaria de Vigilância em Saúde, Coordenação-Geral de Informações e Análises Epidemiológicas. Sistema de Informação sobre Mortalidade, DATASUS [Internet]. 2021 [citado 2022 Jan 5]. Disponível em:
4 Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS et al.; ESC Scientific Document Group. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37(27):2129-200.
5 Koshy AO, Gallivan ER, McGinlay M, Straw S, Drozd M, Toms AG et al. Prioritizing symptom management in the treatment of chronic heart failure. ESC Heart Fail. 2020;7(5):2193-207.
6 Fernández-Martinez J, Romero-Correa M, Salamanca-Bautista P, Aramburu-Bodas Ó, Formiga F, Vázquez-Rodríguez P et al. Prevalence of advanced heart failure and use of palliative care in admitted patients: findings from the EPICTER study. Int J Cardiol. 2021;327:125-31.
7 Zia Khan M, Usman Khan M, Munir MB. Trends and disparities in palliative care encounters in acute heart failure admissions: insight from national inpatient sample. Cardiovasc Revasc Med. 2021;23:52-6.
8 Auld JP, Mudd JO, Gelow JM, Lyons KS, Hiatt SO, Lee CS. Patterns of heart failure symptoms are associated with self-care behaviors over 6 months. Eur J Cardiovasc Nurs. 2018;17(6):543-51.
9 Yancy CW, Jessup M, Bozkurt B, Butler J, Casey Jr DE, Drazner MH et al. 2013 ACCF/AHA Guideline for the management of heart failure: a report of the american college of cardiology foundation/american heart association task force on practice guidelines. Circulation. 2013;128(16):240-327.
10 Ament SMC, van den Broek LM, van den Beuken-van Everdingen MHJ, Boyne JJJ, Maessen JMC, Bekkers SCAM et al. What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study. BMC Palliat Care. 2022;21(1):1-9.
11 Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467-73.
12 Abshire M, Xu JY, Himmelfarb CD, Davidson P, Sulmasy D, Kub J et al. Symptoms and fear in heart failure patients approaching end of life: a mixed methods study. J Clin Nurs. 2015;24(21):3215-23.
13 Agustia Nova P. Chronic heart failure patients’ perceptions on their palliative care needs. Enferm Clin. 2018;28:269-74.
14 Albert NM, Davis M, Young J. Improving the care of patients dying of heart failure. Cleve Clin J Med. 2002;69(4):321-8.
15 Alpert CM, Smith MA, Hummel SL, Hummel EK. Symptom burden in heart failure: assessment, impact on outcomes, and management. Heart Fail Rev. 2017;22(1):25-39.
16 Anderson H, Ward C, Eardley A, Gomm SA, Connolly M, Coppinger T et al. The concerns of patients under palliative care and a heart failure clinic are not being met. Palliat Med. 2001;15(4):279-86.
17 Araújo M, Galriça I, Abril R, Rodrigues R. Cuidados paliativos nas insuficiências de órgão avançadas. Med Interna. 2017;24(3):228-34.
18 Årestedt K, Alvariza A, Boman K, Öhlén J, Goliath I, Håkanson C et al. Symptom relief and palliative care during the last week of life among patients with heart failure: a national register study. J Palliat Med. 2018;21(3):361-7.
19 Årestedt K, Brannstrom M, Evangelista LS, Stromberg A, Alvariza A. Palliative key aspects are of importance for symptom relief during the last week of life in patients with heart failure. ESC Heart Fail. 2021;8(3):2202-9.
20 Bekelman DB, Havranek EP, Becker DM, Kutner JS, Peterson PN, Wittstein IS et al. Symptoms, depression, and quality of life in patients with heart failure. J Card Fail. 2007;13(8):643-8.
21 Bekelman DB, Nowels CT, Allen LA, Shakar S, Kutner JS, Matlock DD. Outpatient palliative care for chronic heart failure: a case series. J Palliat Med. 2011;14(7):815-21.
22 Bekelman DB, Rumsfeld JS, Havranek EP, Yamashita TE, Hutt E, Gottlieb SH et al. Symptom burden, depression, and spiritual well-being: a comparison of heart failure and advanced cancer patients. J Gen Intern Med. 2009;24(5):592-8.
23 Blinderman CD, Homel P, Billings JA, Portenoy RK, Tennstedt SL. Symptom distress and quality of life in patients with advanced congestive heart failure. J Pain Symptom Manage. 2008;35(6):594-603.
24 Dobbie KR, Gandesbery B, Gordeski EZ. Outpatient palliative cardiology embedded within a heart failure clinic: a new model of care. J Palliat Med. 2017;20(4):A11.
25 Flint KM, Fairclough DL, Spertus JA, Bekelman DB. Does heart failure-specific health status identify patients with bothersome symptoms, depression, anxiety, and/or poorer spiritual well-being? Eur Heart J Qual Care Clin Outcomes. 2019;5(3):233-41.
26 Flowers B. Palliative care for patients with end-stage heart failure. Nurs Times. 2003;99(11):30-2. PMid:12683043.
27 Hoyt Zambroski C. Managing beyond an uncertain illness trajectory: palliative care in advanced heart failure. Int J Palliat Nurs. 2006;12(12):566-73.
28 Johnson MJ. Extending palliative care to patients with heart failure. Br J Hosp Med. 2010;71(1):12-5.
29 Jorgenson A, Sidebottom AC, Richards H, Kirven J. A description of inpatient palliative care actions for patients with acute heart failure. Am J Hosp Palliat Care. 2016;33(9):863-70.
30 Kurogi EM, Butcher R, Salvetti MD. Relationship between functional capacity, performance and symptoms in hospitalized patients with heart failure. Rev Bras Enferm. 2020;73(4):e20190123.
31 Lowey SE. Palliative care in the management of patients with advanced heart failure. In: Islam M, editor. Heart failure: from research to clinical practice. Cham: Springer; 2017. (Advances in Experimental Medicine and Biology; no. 1067).
32 Lum HD, Carey EP, Fairclough D, Plomondon ME, Hutt E, Rumsfeld JS et al. Burdensome physical and depressive symptoms predict heart failure-specific health status over one year. J Pain Symptom Manage. 2016;51(6):963-70.
33 Nordgren L, Sörensen S. Symptoms experienced in the last six months of life in patients with end-stage heart failure. Eur J Cardiovasc Nurs. 2003;2(3):213-7.
34 Opasich C, Gualco A. The complex symptom burden of the aged heart failure population. Curr Opin Support Palliat Care. 2007;1(4):255-9.
35 Oriani A, Guo P, Gadoud A, Dunleavy L, Kane P, Murtagh FEM. What are the main symptoms and concerns reported by patients with advanced chronic heart failure?-a secondary analysis of the Palliative care Outcome Scale (POS) and Integrated Palliative care Outcome Scale (IPOS). Ann Palliat Med. 2019;8(5):775-80.
36 Puckett C, Goodlin SJ. A modern integration of palliative care into the management of heart failure. Can J Cardiol. 2020;36(7):1050-60.
37 Riley JP, Beattie JM. Palliative care in heart failure: facts and numbers. ESC Heart Fail. 2017;4(2):81-7.
38 Shah AB, Udeoji DU, Baraghoush A, Bharadwaj P, Yennurajalingam S, Schwarz ER. An evaluation of the prevalence and severity of pain and other symptoms in acute decompensated heart failure. J Palliat Med. 2013;16(1):87-90.
39 Steinberg L, White M, Arvanitis J, Husain A, Mak S. Approach to advanced heart failure at the end of life. Can Fam Physician. 2017;63(9):674-80. PMid:28904030.
40 Stewart D, McPherson ML. Symptom management challenges in heart failure: pharmacotherapy considerations. Heart Fail Rev. 2017;22(5):525-34.
41 Texier G, Rhondali W, Meunier-Lafay E, Dellinger A, Gérard C, Morel V et al. Soins palliatifs chez les patients en insuffisance cardiaque terminale. Ann Cardiol Angeiol. 2014;63(4):253-61.
42 Udeoji DU, Shah AB, Bharadwaj P, Katsiyiannis P, Schwarz ER. Evaluation of the prevalence and severity of pain in patients with stable chronic heart failure. World J Cardiol. 2012;4(8):250-5.
43 Yu DS, Chan HY, Leung DY, Hui E, Sit JW. Symptom clusters and quality of life among patients with advanced heart failure. J Geriatr Cardiol. 2016;13(5):408-14.
44 Zambroski CH, Bekelman DB. Palliative symptom management in patients with heart failure. Prog Palliat Care. 2008;16(5):241-9.
45 Zambroski CH, Moser DK, Roser LP, Heo S, Chung ML. Patients with heart failure who die in hospice. Am Heart J. 2005;149(3):558-64.
46 Freire MCM, Pattussi MP. Tipos de estudos. In: Estrela C, editor. Metodologia científica: ciência, ensino e pesquisa. 3ª ed. Porto Alegre: Artes Médicas, 2018. p. 109-27.
47 Peng X, Tang L. Exercise rehabilitation improves heart function and quality of life in elderly patients with chronic heart failure. J Healthc Eng. 2022;2022:12.
48 Conley S, Feder S, Redeker NS. The relationship between pain, fatigue, depression and functional performance in stable heart failure. Heart Lung. 2015;44(2):107-12.
49 Scrutenid D, Lagioia R, Ricci A, Clemente M, Boni L, Rizzon P. Prediction of mortality in mild to moderately symptomatic patients with left ventricular dysfunction. The role of the New York Heart Association classification, cardiopulmonary exercise testing, two-dimensional echocardiography and Holter monitoring. Eur Heart J. 1994;15(8):1089-95.
50 Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25, 25 Pt B):2889-934.
51 Rabelo ER, Aliti GB, Domingues FB, Ruschel KB, Brun AO. What to teach to patients with heart failure and why: the role of nurses in heart failure clinics. Rev Lat Am Enfermagem. 2007;15(1):165-70.
52 Cavalcanti ACD, Pereira JMV. Nursing diagnoses of patients with heart failure: an integrative review. Online Braz J Nurs. 2014 mar;13(1):113-25.
Submetido em:
13/03/2022
Aceito em:
25/06/2022
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email