Communication with hospitalized heart failure patients

BACKGROUND: Communication with heart failure (HF) patients about their condition and wishes for end-of-life care is recommended in all HF guidelines. AIMS: The aims of this study were to: 1) identify whether hospitalized HF patients want to communicate regarding disease management, prognosis and resuscitation wishes, and 2) to identify the relationship of communication with clinical variables and quality of life (QOL). METHODS: Hospitalized HF patients (n = 47) were asked: 1) Did they want more information about their HF? 2) Did they want to discuss their prognosis? 3) Did they discuss their resuscitation wishes since being hospitalized? RESULTS: Patients' mean age was 62.8 ± 17.0, mean QOL score was 29.4 (0-100) and approximately half (n = 22, 47%) were rehospitalized within 3 months. Twenty-eight (62%) wanted more information regarding disease self-management while 20 (44%) wanted more communication regarding their prognosis. Twenty-four (51%) did not recall a conversation about resuscitation during their hospitalization. Multivariate analysis showed patients who wanted more HF information were 4.4 times more likely to have better NYHA class (p = .02). Patients wanting more communication about their prognosis were more than 4 times more likely to experience future rehospitalizations (p = .03). CONCLUSION: The majority of patients desired more information about HF. A minority had not discussed issues around prognosis, despite their desire to do so. Health care professionals are encouraged to communicate with HF patients about self-management when patients are less symptomatic. More research is needed to explain why patients who wanted more discussion about their prognosis were more likely to be rehospitalized.