The complex and often unpredictable course of heart failure (HF) provides many opportunities
for communication between clinicians and patients about important subjects as advance
care planning, disease state education, therapeutic options and limitations, and end-of-life
care. Studies of patients with HF demonstrate that, when engaging in such complex
communication, specific language matters in patient experience and in shared decision-making
with providers. To date, clinical reports have outlined useful frameworks for communication
with patients with HF but have not yet broached specific language crucial to furthering
whole person care, particularly in the complex and emotional realm of advancing disease
and transitions to end-of-life care. In this work, the investigators unpack language
commonly used in advanced HF care and provide explicit suggestions to better provide
such pivotal communication. In conclusion, specific phrasing may significantly impact
patient experiences and outcomes. Communication that focuses on the disease itself
and the therapy or intervention in question may help remove the patient from potential
negative emotions, thus facilitating more objective shared decision-making with the
clinician.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Palliative care in heart failure: a position statement from the palliative care workshop of the Heart Failure Association of the European Society of Cardiology.Eur J Heart Fail. 2009; 11: 433-443
- Missed opportunities for advance care planning communication during outpatient clinic visits.J Gen Intern Med. 2012; 27: 445-451
- Focused update incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management of heart failure in adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines developed in Collaboration with the International Society for Heart and Lung Transplantation.J Am Coll Cardiol. 2009; 53: e1-e90
- How aware of advanced care directives are heart failure patients, and are they using them?.Can J Cardiol. 2011; 27: 376-381
- “They diagnosed bad heart”: a qualitative exploration of patients' knowledge about and experiences with heart failure.Heart Lung. 2008; 37: 257-265
- Breaking bad news sensitively: what is important to patients in their last year of life?.BMJ Support Palliat Care. 2012; 2: 24-28
- What conversations do bereaved parents remember?.J Palliat Care Med. 2015; 5: 1
- “There's no cure for this condition”: how physicians discuss advance care planning in HF.Patient Educ Couns. 2013; 91: 200-205
- Communication in heart failure: perspectives from older people and primary care professionals.Health Soc Care Community. 2006; 14: 482-490
- Patient-clinician communication about end-of-life care in patients with advanced chronic organ failure during one year.J Pain Symptom Manage. 2015; 49: 1109-1115
- Dying of lung cancer or cardiac failure: prospective qualitative interview study of patients and their carers in the community.BMJ. 2002; 325: 929
- Breaking the “bad” news to patients and families: preparing to have the conversation about end-of-life and hospice care.Am J Geriatr Cardiol. 2004; 13: 307-312
- The power and potential of language.in: Altilio T. Otis-Green S. Oxford Textbook of Palliative Social Work. Oxford University Press, New York, NY2011: 689-695
- Attention and Intention: an invitation to reflection on language.AAPHM Q. 2013; 14: 14-17
- “The Patient failed chemotherapy”…an expunged phrase.Oncologist. 2004; 9 (author reply 719): 719
- Discussing treatment preferences with patients who want “everything.”.Ann Intern Med. 2009; 151: 345-349
- Language matters: “Sometimes we withdraw treatment but we never withdraw care.”.J Palliat Med. 2007; 10: 1239-1240
- Am J Hosp Palliat Care. 2013; 30: 35-39
- Opportunities and challenges for palliative care professionals in the age of health reform.J Hosp Palliat Nurs. 2012; 14: 452-459
Article info
Publication history
Published online: March 17, 2016
Accepted:
March 1,
2016
Received in revised form:
March 1,
2016
Received:
January 11,
2016
Footnotes
See page 1781 for disclosure information.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
