Advanced congestive heart failure: What do patients want?☆,☆☆,★
Section snippets
Methods
This study was undertaken to understand the manner in which patient preferences, family interactions, disease severity, and health care provider beliefs affect the way clinical decisions are made. The project began with a literature review that identified 13 diagnoses that could be evaluated with the standard medical record and had an expected survival of less than 50% at 6 months. After pilot testing was performed, four diagnoses were eliminated, leaving the following nine conditions for
Discussion
The SUPPORT findings provide ample information to confirm that much work is required to improve communication among patients, their family members, and health care providers near the end of life. Patients with heart failure have concerns similar to those of other patients with life-threatening illnesses. In addition, the situation is complex, changes based on new information, and is heavily influenced by personal factors such as depression and social and cultural factors.
Although the prognosis
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Cited by (0)
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From the aDepartment of Medicine and Duke Clinical Research Institute, Duke University Medical Center, Durham; the bDepartment of Cardiology, Marshfield Clinic; and the cDepartment of Medicine, University of California, San Francisco.
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Reprint requests: Robert M. Califf, MD, Duke Clinical Research Institute, 2024 West Main St., Durham, NC 27705.
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