M., Mancini, D., Riegel, B., & Spertus, J. Patient Education and Counselling, 91, 200-205.Īllen, L. How physicians discuss advance care planning in heart failure. Journal of Advanced Nursing published by John Wiley & Sons Ltd.Īhluwalia, S. This theory grounded in data demonstrates the need for both acute and primary care to design an integrative end of life care pathway for heart failure patients which addresses the need for early shared decision making between the healthcare professional, family and the patient when it comes to end of life conversations.Įnd of life care end stage heart failure grounded theory healthcare professional heart failure nurse nursing care palliative care recognizing dying vicious cycle. This study provides a theoretical framework to explain a 'vicious cycle of care' for patients diagnosed with end stage heart failure. Healthcare professionals need to engage in informed decision making with patients to break this 'vicious cycle of care' by identifying key stages in the terminal phase of heart failure and correctly signposting the patient to the most suitable healthcare care professional for intervention. The themes revolved around a core category 'a vicious cycle of heart failure care'. These were: signposting symptoms, organizing care, being informed and recognizing dying. The interviews were recorded and transcribed and the data were analysed using constant comparison and QSR NVivo.įour theoretical categories emerged from the data to explain how healthcare professionals and patients negotiated the process of decision making when considering end of life care. Data were collected using semi-structured interviews and focus groups over a 12-month period of fieldwork concluding in 2017. To explore how healthcare professionals in an acute medical setting make decisions when managing the care of patients diagnosed with end stage heart failure, and how these decisions impact directly on the patient's end of life experience.Ī constructivist grounded theory approach was adopted.Ī purposive sample was used to recruit participants that included 16 registered nurses, 15 doctors and 16 patients.
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