Palliative care needs of heart failure patients: a meta-synthesis of qualitative studies

To systematically evaluate qualitative studies on the palliative care needs of patients with heart failure and conduct a meta-synthesis, aiming to provide evidence-based guidance for developing effective interventions to meet the actual needs of these patients. PubMed, Web of Science, Cochrane Library, Embase, Scopus, CINAHL, CNKI, WanFang Database, VIP, and SinoMed were systematically searched from the inception to February 26, 2026, for qualitative studies reporting the palliative needs of heart failure patients. The inclusion criteria were as follows: (1) Population (P): heart failure patients, their caregivers, and healthcare or hospice clinicians; (2) Interest of phenomena (I): experiences, concerns, and palliative care needs of heart failure patients; (3) Context (Co): healthcare or home care settings; and (4) Study design (S): qualitative studies or mixed-methods studies containing qualitative data. The 2020 version of the Qualitative Research Quality Evaluation Standard issued by the Joanna Briggs Institute (JBI) was used for literature quality assessment, and the JBI meta-aggregative method was employed for meta-synthesis. A total of 13 studies were included, involving 210 heart failure patients, 22 healthcare providers and hospice clinicians, and 31 caregivers. Most of the included studies were descriptive qualitative studies. These were ultimately integrated into 5 synthesized themes and 15 research categories: physical needs (restoring physiological function, alleviating suffering; maintaining daily living abilities); psychological and spiritual needs (relief of negative emotions and psychological adjustment; privacy and respect; spiritual needs); social support needs (love and companionship of family; support from friends and relatives; professional support; social health insurance and financial assistance); caring and end-of-life decision-making needs (advance care planning; continuity of care; personalized care); and information and communication needs (disease knowledge; palliative care knowledge; communication and understanding). The palliative care needs of patients with heart failure are diverse. Future palliative care should focus on developing a patient‑need‑oriented comprehensive palliative care framework that integrates ongoing symptom management, multidimensional social support, psychological‑spiritual care, individualized end‑of‑life‑decision guidance and tailored information‑communication strategies to optimize palliative care services for heart failure patients.