Key result
Fear of death was present in 16% of elderly heart failure patients during deterioration and significantly correlated with anxiety and depression at 6 months (r=0.40, P<0.001).
Observational (n=145)
Effect estimate: r=0.40
p-value: p=<0.001
In elderly patients hospitalized for heart failure deterioration, thoughts about death are common and fear of death is significantly correlated with anxiety and depression.
May warrant psychological assessment for fear of death in elderly HF inpatients; leaves open whether targeted support reduces later anxiety and depression.
Aim To explore thoughts about death and perceived health status in elderly patients with heart failure during a 6month period after a deterioration needing hospitalisation. Methods A descriptive, mixed methods design was used. Health was measured with EuroQol-5D, thoughts about death with multiple choice and open questions. A total of 145 patients with New York Heart Association class II–IV heart failure, mean age 70 years, 70% males, were included. Results During deterioration, 16% of the patients were afraid of dying and 4% had this fear very often. Fear of death did not change significantly during the 6 months after deterioration. Both during deterioration (r=0.26, P<0.01) and 6months later (r=0.40, P<0.001), fear of death and anxiety/depression were correlated. Content analysis of the open question produced 5 categories: (1) Death as a natural part of life; (2) Death as a relief from symptoms and disability (3) Death as fearful (4) Arrangements for time after death (5) A wish for an extended life. Conclusion Elderly patients with heart failure had a lot of thoughts about death. Higher levels of anxiety/depression were correlated to fear of death. Many expressed death as a natural relief from suffering, others were afraid of pain, loss of independence and dignity.
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Strömberg et al. (2008) conducted an observational in Heart failure (n=145). Fear of death was present in 16% of elderly heart failure patients during deterioration and significantly correlated with anxiety and depression at 6 months (r=0.40, P<0.001).