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Erschienen in:

01.05.2009 | Original Article

Symptom Burden, Depression, and Spiritual Well-Being: A Comparison of Heart Failure and Advanced Cancer Patients

verfasst von: David B. Bekelman, MD, MPH, John S. Rumsfeld, MD, PhD, Edward P. Havranek, MD, Traci E. Yamashita, MS, Evelyn Hutt, MD, Sheldon H. Gottlieb, MD, Sydney M. Dy, MSc, Jean S. Kutner, MD, MSPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 5/2009

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ABSTRACT

BACKGROUND

A lower proportion of patients with chronic heart failure receive palliative care compared to patients with advanced cancer.

OBJECTIVE

We examined the relative need for palliative care in the two conditions by comparing symptom burden, psychological well-being, and spiritual well-being in heart failure and cancer patients.

DESIGN

This was a cross-sectional study.

PARTICIPANTS

Sixty outpatients with symptomatic heart failure and 30 outpatients with advanced lung or pancreatic cancer.

MEASUREMENTS

Symptom burden (Memorial Symptom Assessment Scale-Short Form), depression symptoms (Geriatric Depression Scale-Short Form), and spiritual well-being (Functional Assessment of Chronic Illness Therapy—Spiritual Well-Being scale).

MAIN RESULTS

Overall, the heart failure patients and the cancer patients had similar numbers of physical symptoms (9.1 vs. 8.6, p = 0.79), depression scores (3.9 vs. 3.2, p = 0.53), and spiritual well-being (35.9 vs. 39.0, p = 0.31) after adjustment for age, gender, marital status, education, and income. Symptom burden, depression symptoms, and spiritual well-being were also similar among heart failure patients with ejection fraction ≤30, ejection fraction >30, and cancer patients. Heart failure patients with worse heart failure-related health status had a greater number of physical symptoms (13.2 vs. 8.6, p = 0.03), higher depression scores (6.7 vs. 3.2, p = 0.001), and lower spiritual well-being (29.0 vs. 38.9, p < 0.01) than patients with advanced cancer.

CONCLUSIONS

Patients with symptomatic heart failure and advanced cancer have similar needs for palliative care as assessed by symptom burden, depression, and spiritual well-being. This implies that heart failure patients, particularly those with more severe heart failure, need the option of palliative care just as cancer patients do.

MacIntyre K, Capewell S, Stewart S, et al. Evidence of improving prognosis in heart failure: trends in case fatality in 66 547 patients hospitalized between 1986 and 1995. Circulation. 2000;102(10):1126–31.PubMed

Krumholz HM, Parent EM, Tu N, et al. Readmission after hospitalization for congestive heart failure among Medicare beneficiaries. Arch Intern Med. 1997;157(1):99–104.PubMedCrossRef

Stewart S, MacIntyre K, Hole DJ, Capewell S, McMurray JJ. More ‘malignant’ than cancer? Five-year survival following a first admission for heart failure. Eur J Heart Fail. 2001;3(3):315–22.PubMedCrossRef

Zambroski CH, Moser DK, Bhat G, Ziegler C. Impact of symptom prevalence and symptom burden on quality of life in patients with heart failure. Eur J Cardiovasc Nurs. 2005;4(3):198–206.PubMedCrossRef

Bekelman DB, Havranek EP, Becker DM, et al. Symptoms, depression, and quality of life in patients with heart failure. J Card Fail. 2007;13(8):643–8.PubMedCrossRef

Rumsfeld JS, Havranek E, Masoudi FA, et al. Depressive symptoms are the strongest predictors of short-term declines in health status in patients with heart failure. J Am Coll Cardiol. 2003;42(10):1811–7.PubMedCrossRef

Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol. 2006;48(8):1527–37.PubMedCrossRef

Talback M, Stenbeck M, Rosen M, Barlow L, Glimelius B. Cancer survival in Sweden 1960–1998–developments across four decades. Acta Oncol. 2003;42(7):637–59.PubMedCrossRef

Tishelman C, Petersson LM, Degner LF, Sprangers MA. Symptom prevalence, intensity, and distress in patients with inoperable lung cancer in relation to time of death. J Clin Oncol. 2007;25(34):5381–9.PubMedCrossRef

10.

Labori KJ, Hjermstad MJ, Wester T, Buanes T, Loge JH. Symptom profiles and palliative care in advanced pancreatic cancer: a prospective study. Support Care Cancer. 2006;14(11):1126–33.PubMedCrossRef

11.

Muller-Nordhorn J, Roll S, Bohmig M, et al. Health-related quality of life in patients with pancreatic cancer. Digestion. 2006;74(2):118–25.PubMedCrossRef

12.

Morrison RS, Meier DE. Clinical practice. Palliative care. N Engl J Med. 2004;350(25):2582–90.PubMedCrossRef

13.

Riegel B, Moser DK, Powell M, Rector TS, Havranek EP. Nonpharmacologic care by heart failure experts. J Card Fail. 2006;12(2):149–53.PubMedCrossRef

14.

Murray SA, Boyd K, Kendall M, Worth A, Benton TF, Clausen H. Dying of lung cancer or cardiac failure: prospective qualitative interview study of patients and their carers in the community. BMJ. 2002;325(7370):929.PubMedCrossRef

15.

Murray SA, Kendall M, Boyd K, Worth A, Benton TF. Exploring the spiritual needs of people dying of lung cancer or heart failure: a prospective qualitative interview study of patients and their carers. Palliat Med. 2004;18(1):39–45.PubMedCrossRef

16.

Horne G, Payne S. Removing the boundaries: palliative care for patients with heart failure. Palliat Med. 2004;18(4):291–6.PubMedCrossRef

17.

Bekelman DB, Dy SM, Becker DM, et al. Spiritual well-being and depression in patients with heart failure. J Gen Intern Med. 2007;22(4):470–7.PubMedCrossRef

18.

National Comprehensive Cancer Network I. The NCCN Clinical Practice Guidelines in Oncology. Available at www.nccn.org. Accessed February 5, 2009.

19.

Chang VT, Hwang SS, Feuerman M, Kasimis BS, Thaler HT. The memorial symptom assessment scale short form (MSAS-SF). Cancer. 2000;89(5):1162–71.PubMedCrossRef

20.

Tranmer JE, Heyland D, Dudgeon D, Groll D, Squires-Graham M, Coulson K. Measuring the symptom experience of seriously ill cancer and noncancer hospitalized patients near the end of life with the memorial symptom assessment scale. J Pain Symptom Manage. 2003;25(5):420–9.PubMedCrossRef

21.

Yesavage JA, Sheikh JI. Geriatric depression scale (GDS): recent evidence and development of a shorter version. Clinical Gerontology. 1986;6:165–73.CrossRef

22.

Yesavage JA. Geriatric Depression Scale. Psychopharmacol Bull. 1988;24(4):709–11.PubMed

23.

Whooley MA, Browner WS. Association between depressive symptoms and mortality in older women. Study of Osteoporotic Fractures Research Group. Arch Intern Med. 1998;158(19):2129–35.PubMedCrossRef

24.

Weintraub D, Saboe K, Stern MB. Effect of age on geriatric depression scale performance in Parkinson’s disease. Mov Disord. 2007;22(9):1331–5.PubMedCrossRef

25.

Ferraro FR, Chelminski I. Preliminary normative data on the Geriatric Depression Scale-Short Form (GDS-SF) in a young adult sample. J Clin Psychol. 1996;52(4):443–7.PubMedCrossRef

26.

Rule BG, Harvey HZ, Dobbs AR. Reliability of the geriatric depression scale for younger adults. Clinical Gerontologist. 1989;9:37–43.CrossRef

27.

Arthur A, Jagger C, Lindesay J, Graham C, Clarke M. Using an annual over-75 health check to screen for depression: validation of the short Geriatric Depression Scale (GDS15) within general practice. Int J Geriatr Psychiatry. 1999;14(6):431–9.PubMedCrossRef

28.

Peterman AH, Fitchett G, Brady MJ, Hernandez L, Cella D. Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy–Spiritual Well-being Scale (FACIT-Sp). Ann Behav Med. 2002;24(1):49–58.PubMedCrossRef

29.

McClain CS, Rosenfeld B, Breitbart W. Effect of spiritual well-being on end-of-life despair in terminally-ill cancer patients. Lancet. 2003;361(9369):1603–7.PubMedCrossRef

30.

Green CP, Porter CB, Bresnahan DR, Spertus JA. Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: a new health status measure for heart failure. J Am Coll Cardiol. 2000;35(5):1245–55.PubMedCrossRef

31.

Spertus J, Peterson E, Conard MW, et al. Monitoring clinical changes in patients with heart failure: a comparison of methods. Am Heart J. 2005;150(4):707–15.PubMedCrossRef

32.

Heidenreich PA, Spertus JA, Jones PG, et al. Health status identifies heart failure outpatients at risk for hospitalization or death. J Am Coll Cardiol. 2006;47(4):752–6.PubMedCrossRef

33.

Walke LM, Gallo WT, Tinetti ME, Fried TR. The burden of symptoms among community-dwelling older persons with advanced chronic disease. Arch Intern Med. 2004;164(21):2321–4.PubMedCrossRef

34.

Berard RM, Boermeester F, Viljoen G. Depressive disorders in an out-patient oncology setting: prevalence, assessment, and management. Psychooncology. 1998;7(2):112–20.PubMedCrossRef

35.

Murray SA, Kendall M, Grant E, Boyd K, Barclay S, Sheikh A. Patterns of social, psychological, and spiritual decline toward the end of life in lung cancer and heart failure. J Pain Symptom Manage. 2007;34(4):393–402.PubMedCrossRef

36.

Masoudi FA, Rumsfeld JS, Havranek EP, et al. Age, functional capacity, and health-related quality of life in patients with heart failure. J Card Fail. 2004;10(5):368–73.PubMedCrossRef

37.

Hauptman PJ, Havranek EP. Integrating palliative care into heart failure care. Arch Intern Med. 2005;165(4):374–8.PubMedCrossRef

38.

Goodlin SJ, Hauptman PJ, Arnold R, et al. Consensus statement: Palliative and supportive care in advanced heart failure. J Card Fail. 2004;10(3):200–9.PubMedCrossRef

39.

Pantilat SZ, Steimle AE. Palliative care for patients with heart failure. JAMA. 2004;291(20):2476–82.PubMedCrossRef

40.

Hunt SA, Abraham WT, Chin MH, et al. ACC/AHA 2005 Guideline update for the diagnosis and management of chronic heart failure in the adult: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing committee to update the 2001 Guidelines for the evaluation and management of heart failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005;112(12):e154–e235.PubMedCrossRef

41.

Addington-Hall JM, Gibbs JS. Heart failure now on the palliative care agenda. Palliat Med. 2000;14(5):361–2.PubMedCrossRef

42.

Athavale NV. Palliative care is an important aspect of heart failure management. Age Ageing. 2003;32(1):117–8.PubMedCrossRef

43.

Gibbs JS, McCoy AS, Gibbs LM, Rogers AE, Addington-Hall JM. Living with and dying from heart failure: the role of palliative care. Heart. 2002;88(Suppl 2):ii36–9.PubMed

44.

Gottlieb SH. Palliative care in heart failure. Heart. 2003;3(8):326–35.

45.

Lewis C, Stephens B. Improving palliative care provision for patients with heart failure. Br J Nurs. 2005;14(10):563–7.PubMed

46.

Stewart S, McMurray JJ. Palliative care for heart failure. BMJ. 2002; 325(7370):915–6.PubMedCrossRef

47.

Ward C. The need for palliative care in the management of heart failure. Heart. 2002;87(3):294–8.PubMedCrossRef

48.

Woodend AK. What’s new in palliative care for patients with heart failure? Can J Cardiovasc Nurs. 2005;15(2):3–4.

49.

Hunt SA, Abraham WT, Chin MH, et al. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing committee to update the 2001 Guidelines for the evaluation and management of heart failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005;112(12):e154–235.PubMedCrossRef

50.

Field MJ, Cassel CK, ed. Approaching Death: Improving Care at the End of Life. Washington, D.C.: National Academy Press; 1997.

51.

Bristow MR, Saxon LA, Boehmer J, et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. 2004;350(21):2140–50.PubMedCrossRef

52.

Cleland JG, Daubert JC, Erdmann E, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005;352(15):1539–49.PubMedCrossRef

53.

Dalal S, Del Fabbro E, Bruera E. Symptom control in palliative care–Part I: oncology as a paradigmatic example. J Palliat Med. 2006;9(2):391–408.PubMedCrossRef

54.

Del Fabbro E, Dalal S, Bruera E. Symptom control in palliative care–Part III: dyspnea and delirium. J Palliat Med. 2006;9(2):422–36.PubMedCrossRef

55.

Del Fabbro E, Dalal S, Bruera E. Symptom control in palliative care–Part II: cachexia/anorexia and fatigue. J Palliat Med. 2006;9(2):409–21.PubMedCrossRef

56.

Higginson IJ, Finlay I, Goodwin DM, et al. Do hospital-based palliative teams improve care for patients or families at the end of life? J Pain Symptom Manage. 2002;23(2):96–106.PubMedCrossRef

57.

Glassman AH, O’Connor CM, Califf RM, et al. Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA. 2002;288(6):701–9.PubMedCrossRef

58.

Gottlieb SS, Kop WJ, Thomas SA, et al. A double-blind placebo-controlled pilot study of controlled-release paroxetine on depression and quality of life in chronic heart failure. Am Heart J. 2007;153(5):868–73.PubMedCrossRef

59.

Berkman LF, Blumenthal J, Burg M, et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial. JAMA. 2003;289(23):3106–116.PubMedCrossRef

60.

Coulehan JL, Platt FW, Egener B, et al. “Let me see if i have this right…": words that help build empathy. Ann Intern Med. 2001;135(3):221–7.PubMed

61.

Reynolds CF III, Dew MA, Pollock BG, et al. Maintenance treatment of major depression in old age. N Engl J Med. 2006;354(11):1130–8.PubMedCrossRef

62.

Unutzer J, Katon W, Callahan CM, et al. Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA. 2002;288(22):2836–45.PubMedCrossRef

63.

Havranek EP, Masoudi FA, Westfall KA, Wolfe P, Ordin DL, Krumholz HM. Spectrum of heart failure in older patients: results from the National Heart Failure project. Am Heart J. 2002;143(3):412–7.PubMedCrossRef

64.

Ehman JW, Ott BB, Short TH, Ciampa RC, Hansen-Flaschen J. Do patients want physicians to inquire about their spiritual or religious beliefs if they become gravely ill? Arch Intern Med. 1999;159(15):1803–6.PubMedCrossRef

65.

Brady MJ, Peterman AH, Fitchett G, Mo M, Cella D. A case for including spirituality in quality of life measurement in oncology. Psychooncology. 1999;8(5):417–28.PubMedCrossRef

66.

Chochinov HM, Hack T, Hassard T, Kristjanson LJ, McClement S, Harlos M. Dignity therapy: a novel psychotherapeutic intervention for patients near the end of life. J Clin Oncol. 2005;23(24):5520–5.PubMedCrossRef

67.

Breitbart W. Spirituality and meaning in supportive care: spirituality- and meaning-centered group psychotherapy interventions in advanced cancer. Support Care Cancer. 2002;10(4):272–80.PubMedCrossRef

Titel: Symptom Burden, Depression, and Spiritual Well-Being: A Comparison of Heart Failure and Advanced Cancer Patients
verfasst von: David B. Bekelman, MD, MPH
John S. Rumsfeld, MD, PhD
Edward P. Havranek, MD
Traci E. Yamashita, MS
Evelyn Hutt, MD
Sheldon H. Gottlieb, MD
Sydney M. Dy, MSc
Jean S. Kutner, MD, MSPH
Publikationsdatum: 01.05.2009
Verlag: Springer-Verlag
Erschienen in: Journal of General Internal Medicine / Ausgabe 5/2009
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-009-0931-y

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Symptom Burden, Depression, and Spiritual Well-Being: A Comparison of Heart Failure and Advanced Cancer Patients

ABSTRACT

BACKGROUND

OBJECTIVE

DESIGN

PARTICIPANTS

MEASUREMENTS

MAIN RESULTS

CONCLUSIONS

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ABSTRACT

BACKGROUND

OBJECTIVE

DESIGN

PARTICIPANTS

MEASUREMENTS

MAIN RESULTS

CONCLUSIONS

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