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dc.contributor.authorAnderson, Heather
dc.contributor.authorWard, Christopher M
dc.contributor.authorEardley, Anne
dc.contributor.authorGomm, S A
dc.contributor.authorConnolly, M
dc.contributor.authorCoppinger, T
dc.contributor.authorCorgie, Delphine
dc.contributor.authorWilliams, J L
dc.contributor.authorMakin, Wendy P
dc.date.accessioned2009-10-13T10:52:59Z
dc.date.available2009-10-13T10:52:59Z
dc.date.issued2001-07
dc.identifier.citationThe concerns of patients under palliative care and a heart failure clinic are not being met. 2001, 15 (4):279-86 Palliat Meden
dc.identifier.issn0269-2163
dc.identifier.pmid12054145
dc.identifier.doi10.1191/026921601678320269
dc.identifier.urihttp://hdl.handle.net/10541/84163
dc.description.abstractPatients with a terminal illness, identified by palliative care teams working in Manchester, and patients attending a heart failure clinic, were asked to participate in a prospective survey to determine their main concerns. Data were collected from 213 palliative care (PC) patients (mostly with cancer) and 66 patients with heart failure (HF). The median ages of the two patient groups were similar, but the HF patients were more likely to be male and living with a partner; 13% of PC and 7% of HF patients reported that they had no carer. The PC patients had more district nurse, hospice, social work and physiotherapy input. The most frequently reported troublesome problems for PC patients were pain (49%), loss of independence (30%) and difficulty walking (27%). HF patients reported dyspnoea (55%), angina (32%) and tiredness (27%) as the most troublesome problems. From a checklist of symptoms, the frequency of tiredness (PC = 77%, HF = 82%) and difficulty getting about (PC = 71%, HF = 65%) were high in each group. Psychological problems were reported by 61% of PC and 41% of HF patients. Cardiac patients reported more breathlessness and cough than PC patients (83% vs 49% and 44% vs 26%, respectively). Reduced libido was more common in cardiac patients (42% vs 21%). Patient disclosure of troublesome problems to professional carers was high (>87% in both PC and HF patients). Documented action was greater for physical than social or psychological problems. For PC patients, documented action was recorded for 83% physical, 43% social/functional and 52% psychological problems. For HF patients documented action was recorded for 74% cardiac, 60% physical - non-cardiac, 30% social/functional and 28% psychological problems. Clearly many patients' troublesome problems were not being addressed. As a result of this study, specific action by health care professionals was taken in 50% of PC patients and 71% of HF patients. We plan to target specific educational events on the treatment of physical problems, psychological assessment and social service provision.
dc.language.isoenen
dc.subjectCanceren
dc.subject.meshActivities of Daily Living
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAged, 80 and over
dc.subject.meshEngland
dc.subject.meshFemale
dc.subject.meshHealth Care Surveys
dc.subject.meshHeart Failure
dc.subject.meshHumans
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshNeoplasms
dc.subject.meshOutpatient Clinics, Hospital
dc.subject.meshPalliative Care
dc.subject.meshPatient Acceptance of Health Care
dc.subject.meshPatient Satisfaction
dc.subject.meshProfessional-Patient Relations
dc.subject.meshProspective Studies
dc.subject.meshTerminal Care
dc.titleThe concerns of patients under palliative care and a heart failure clinic are not being met.en
dc.typeArticleen
dc.contributor.departmentDepartment of Clinical Audit and Quality Assurance, Christie Hospital, Manchester, UK.en
dc.identifier.journalPalliative Medicineen
html.description.abstractPatients with a terminal illness, identified by palliative care teams working in Manchester, and patients attending a heart failure clinic, were asked to participate in a prospective survey to determine their main concerns. Data were collected from 213 palliative care (PC) patients (mostly with cancer) and 66 patients with heart failure (HF). The median ages of the two patient groups were similar, but the HF patients were more likely to be male and living with a partner; 13% of PC and 7% of HF patients reported that they had no carer. The PC patients had more district nurse, hospice, social work and physiotherapy input. The most frequently reported troublesome problems for PC patients were pain (49%), loss of independence (30%) and difficulty walking (27%). HF patients reported dyspnoea (55%), angina (32%) and tiredness (27%) as the most troublesome problems. From a checklist of symptoms, the frequency of tiredness (PC = 77%, HF = 82%) and difficulty getting about (PC = 71%, HF = 65%) were high in each group. Psychological problems were reported by 61% of PC and 41% of HF patients. Cardiac patients reported more breathlessness and cough than PC patients (83% vs 49% and 44% vs 26%, respectively). Reduced libido was more common in cardiac patients (42% vs 21%). Patient disclosure of troublesome problems to professional carers was high (>87% in both PC and HF patients). Documented action was greater for physical than social or psychological problems. For PC patients, documented action was recorded for 83% physical, 43% social/functional and 52% psychological problems. For HF patients documented action was recorded for 74% cardiac, 60% physical - non-cardiac, 30% social/functional and 28% psychological problems. Clearly many patients' troublesome problems were not being addressed. As a result of this study, specific action by health care professionals was taken in 50% of PC patients and 71% of HF patients. We plan to target specific educational events on the treatment of physical problems, psychological assessment and social service provision.


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