Page 120 - HA Convention 2015

Service Priorities and Programmes Free Papers

SPP3.3 Clinical Safety and Quality Service I 14:30 Room 221

Monday, 18 May Improving Outcomes on End Stage Heart Failure Patients by Palliative Nurse Follow-up
Ng AYM 1, Wong FKY 1, Ng JSC 2, Lam PT 3, Tang SK 3, Cheung KK 3, Ng NHY 3, Tsang YY 3, Cheng SH 3, Wong KL 3
1School of Nursing, The Hong Kong Polytechnic University, 2Department of Medicine, Haven of Hope Hospital,
3Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong

Introduction

Initiating palliative care (PC) for end-stage heart failure (ESHF) patients is a global trend. Heart failure remains a common
cause of death. The possibility of imminent death is prominent when the disease progresses to end-stage; symptom burden
increases as the patient deteriorates. The provision of PC helps the patients to control symptoms and maintain quality of life
but the effect evidence is yet to be established.

Objectives

The aim of this study is to examine whether the study group receiving structured PC nurse intervention has better patient
outcomes than the control group receiving customary care.

Methodology

This is a randomised controlled trial conducted in the medicine and geriatric department at United Christian Hospital. Heart
failure patients who fulfilled the study inclusion criteria were approached. 52 patients participated in the study from April
2013 to July 2014. The control group received customary hospital service including outpatient clinic consultation and on-
demand home care. The study group received structured and standardised palliative nurse home visit and telephone follow-
up supported by mutual goal setting between the patient and the nurse. The outcome measures included quality of life,
symptom profile and satisfaction of care.

Results

Amongst the 52 participants, 28 were in intervention group and 24 were in control group. Statistically significant within group
effects were found for symptom on dyspnoea (5.70 vs. 4.99, p=0.014) and the total score in the heart failure specific quality of
life questionnaire (18.12 vs. 20.17, p=0.015) in the study group (n=28) but not the control group (n=24). The intervention group
had significantly higher satisfaction of care (45.76 vs 37.88, p=0.016). Dyspnoea, tiredness and pain were the most common
symptoms reported for all patients.

Conclusion

Patients with ESHF suffer from multiple symptoms and life distress. The palliative nurse follow-up for post-discharge ESHF
patients can help control patient symptoms, enhance quality of life and satisfaction of care.

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