Decision Making Among Persons Living With Heart Failure.
Jiayun Xu, Martha Abshire, Hae-Ra Han
PMID 26646597WHAT IT FOUND
Most research on decisions by people with heart failure focused on end-of-life choices.
Acute symptoms often sent patients to emergency care, while gradual symptoms prompted calls to providers. Evidence comes from small studies with mixed results.
Key findings
01Two thirds of the included studies examined end-of-life decisions, including resuscitation, advance care planning, ICD deactivation, location of death, and identifying a substitute decision maker.
02Acute symptoms were a common cue for seeking care; chronic or progressive symptoms were more likely to lead to calling the care provider, while acute symptoms led to emergency care.
03In one small study of 36 participants, a palliative care consultation increased completion of advanced directives from 28% to 47%; in another survey of 41 participants, 76% had completed a will.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only 12 articles met the search criteria, so the review covers a narrow slice of the literature. Most included studies had small samples, and only 2 reported calculating how many participants were needed. Half the studies did not report race, sex, or education, and samples were mostly White and male, unlike the general heart failure population. Many studies measured decisions at one point only, so they cannot show how decisions change over time. Only three studies used tested decision measures; others wrote their own questions. The review included only English-language database articles and may have missed studies that used different decision terms. Included studies did not necessarily have decision-making as their primary purpose.
The easy way to misread this
Do not read this as evidence that one decision support approach works for all people with heart failure. The review included few studies, many with small samples, and most focused on end-of-life choices rather than routine daily decisions.