En undersøgelse af hvad mennesker med hjertesvigt finder meningsfuldt i integrerede sessioner med en palliativ tilgang

Purpose and Background: In the field of general palliative care as it is integrated into heart failure treatment, it is essential to explore the patient experience and build on this knowledge for the further development of palliative care practice and policy. Based on an intervention study, I explored what heart failure patients found significant in integrated palliative care sessions using a narrative approach.
Material and Methods: I conducted a semi-structured interview study with a qualitative analysis focused on meaning making. The analysis was further interpreted using theory and additional research from the field. The inclusion criteria for the intervention were 1) a new diagnosis of heart failure, 2) follow-up treatment at this local heart failure clinic, and 3) informed consent to participate in the integrated palliative care intervention. The only exclusion criterion was if the patient was already engaged in a palliative care program. 20 patients agreed to participate in the intervention, and 12 of these completed the integrated palliative care sessions and participated in this interview study. The study followed the guidelines of Consolidated Criteria for Reporting Qualitative Research (COREQ).
Results: Overall, the analysis showed that the integrated palliative care sessions with a narrative approach were successful in joining an embodied patient perspective with a medical perspective. The thematic analysis resulted in three themes supporting the overall findings: sessions bring comfort, telling your story provides a sense of meaningfulness, and integrating perspectives of heart failure into everyday life.
Discussion and Conclusion: The method using the narrative approach in integrated palliative care sessions was significant in various ways. First, patients experienced a calm and safe atmosphere and perceived that the nurse was truly interested in them. Second, the narrative approach were able to bring comfort to lived physical, psychosocial and existential issues. Last, it allowed patients to combine their embodied understanding of heart failure with a medical perspective, thereby finding meaning in the sense of how everything is connected. These findings are in agreement with the aim of palliative care and provide a ‘real-life’ argument for an integrated approach to palliative care in heart failure treatment.
Supervisor/senior researcher: Helle Timm, Professor, SIF [email protected] and Charlotte Simonÿ, senior researcher at PROgrez, NSR Hospitals [email protected]

Funding: The local research fund at NSR Hospitals, Medicine 2 NSR Hospitals and Region Zealand