Key result
A novel questionnaire assessing barriers to goals of care discussions in advanced heart failure demonstrated feasibility with a 58% response rate, identifying family difficulty accepting a poor prognosis as the most important barrier.
Cross-Sectional (n=44)
No
A novel questionnaire assessing barriers to goals of care discussions in advanced heart failure is feasible and identified patient and family factors as the most significant perceived barriers among cardiology clinicians.
May inform training on family barriers in advanced HF goals-of-care; leaves open prospective validation of questionnaire impact.
AIMS: Good end-of-life communication and decision-making are important to patients with advanced heart failure (HF) and their families, but their needs remain unmet. In this pilot study, we describe the feasibility and performance of a novel questionnaire aimed at identifying barriers and solutions to improve communication and decision-making about goals of care for hospitalized patients with advanced HF. METHODS: We distributed questionnaires to staff cardiologists, cardiology trainees, and cardiology nurses who provide care for HF patients at a Canadian teaching hospital. The questionnaire asked about the importance of various barriers to goals of care discussions. It also asked participants to rank their willingness to engage in goals of care discussions and their views on other clinicians could engage in such discussions. RESULTS: Of 76 clinicians, 44 (58%) completed the questionnaire (median completion time, 17 min). Individual survey questions had few missing responses (0% to 2%) for questions about barriers to goals of care discussions. There was appreciable discrimination of the importance of different barriers (mean scores 2.2 to 6.0 on a 7-point scale). Preliminary data suggest that clinicians perceive patient and family factors, such as difficulty accepting a poor prognosis, as the most important barriers preventing goals of care discussions. CONCLUSIONS: In this pilot study, we have demonstrated the feasibility of a novel questionnaire to be used in a larger multi-centre study of end-of-life HF care. Essential information will be obtained to inform the design and evaluation of interventions that seek to improve communication and decision-making about goals of care with HF patients.
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Aleksova et al. (2016) conducted a cross-sectional in Clinicians providing care for heart failure patients (n=44). DECIDE-HF questionnaire was evaluated on Feasibility (response rate) and performance (missing responses, importance scores) of the questionnaire. A novel questionnaire assessing barriers to goals of care discussions in advanced heart failure demonstrated feasibility with a 58% response rate, identifying family difficulty accepting a poor prognosis as the most important barrier.
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