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Identifying and addressing the four types of patient work (managing illness, everyday work, biographical work, arrangement work) can improve palliative care quality for end-stage heart failure patients.
OBJECTIVE: The most recent WHO definition of palliative care regards living as actively as possible as an important aim. We explored, over a 1-year period, the work this involves for patients with end-stage heart failure. DESIGN: Prospective longitudinal multiple case study using qualitative interview techniques. PARTICIPANTS: Thirty-one respondents from two hospitals who fulfilled one or more of the following criteria: NYHA III or IV, ejection fraction <25%, at least one hospitalization for heart failure. MAIN OUTCOMES: Types and content of patient work involved in living with end-stage heart failure. RESULTS: For patients with advanced heart failure, work consisted mainly of four types of tasks, as identified by Glaser and Strauss: 'managing illness', 'everyday work to keep life going', 'biographical work' and 'arrangement work'. CONCLUSIONS: Systematic attention to patient work, for example using these four categories, could improve the quality of care from the patient's perspective.
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Willems et al. (2006) studied this question.
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