Prognostic Understanding and Preference for the Communication Process with Physicians in Hospitalized Heart Failure Patients
2020; Elsevier BV; Volume: 27; Issue: 3 Linguagem: Inglês
10.1016/j.cardfail.2020.10.009
ISSN1532-8414
AutoresHiroki Kitakata, Takashi Kohno, Shun Kohsaka, Daisuke Fujisawa, Naomi Nakano, Yasuyuki Shiraishi, Yoshinori Katsumata, Shinsuke Yuasa, Keiichi Fukuda,
Tópico(s)Chronic Disease Management Strategies
ResumoBackground Heart failure (HF) is a highly prevalent, heterogeneous, and life-threatening condition. Precise prognostic understanding is essential for effective decision making, but little is known about patients' attitudes toward prognostic communication with their physicians. Methods and Results We conducted a questionnaire survey, consisting of patients' prognostic understanding, preferences for information disclosure, and depressive symptoms, among hospitalized patients with HF (92 items in total). Individual 2-year survival rates were calculated using the Seattle Heart Failure Model, and its agreement level with patient self-expectations of 2-year survival were assessed. A total of 113 patients completed the survey (male 65.5%, median age 75.0 years, interquartile range 66.0–81.0 years). Compared with the Seattle Heart Failure Model prediction, patient expectation of 2-year survival was matched only in 27.8% of patients; their agreement level was low (weighted kappa = 0.11). Notably, 50.9% wished to know "more," although 27.7% felt that they did not have an adequate prognostic discussion. Compared with the known prognostic variables (eg, age and HF severity), logistic regression analysis demonstrated that female and less depressive patients were associated with patients' preference for "more" prognostic discussion. Conclusions Patients' overall prognostic understanding was suboptimal. The communication process requires further improvement for patients to accurately understand their HF prognosis and be involved in making a better informed decision.
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