Symptom burden, depression, and spiritual well-being: a comparison of heart failure and advanced cancer patients
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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 < or =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.
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As symptoms worsen, many CHF patients become dependent on carers, which adversely affects their sense of identity and will to live.
“As symptoms worsen, many CHF patients become dependent on carers, which adversely affects their sense of identity and will to live. 6 , 15”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [6]
The Results (page not provided) link worse heart-failure health status with greater symptom burden and worse spiritual well-being; the Introduction also describes functional limitations. The paper does not establish that worsening symptoms cause dependence on carers or damage patients’ sense of identity and will to live. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe symptom burden for CHF patients has been likened to those with advanced cancer or acquired immune deficiency syndrome.
“The symptom burden for CHF patients has been likened to those with advanced cancer or acquired immune deficiency syndrome, 6 , 12”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [6]
The Results (page unavailable) report similar symptom burden in outpatients with symptomatic heart failure and advanced cancer. The paper compares heart failure with advanced lung or pancreatic cancer, but our copy does not address acquired immune deficiency syndrome; a search for AIDS found no relevant passage. (LLM, conf=0.88)
Experimental — accuracy not yet measuredDespite optimal medical management and device therapy, patients often have persistent symptoms and long-term reductions in quality of life.
“Despite optimal medical management and device therapy, patients often have persistent symptoms and long‐term reductions in quality of life (QoL)”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [6]
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Self-citation
- Authors
- Bekelman, D. B., Rumsfeld, J. S., Havranek, E. P., Yamashita, T. E., Hutt, E., Gottlieb, S. H., Dy, S. M., & Kutner, J. S.
- Affiliations
- University of Colorado Anschutz (US)
- VA Eastern Colorado Health Care System (US)
- Denver Health Medical Center (US)
- Johns Hopkins Bayview Medical Center (US)
- Johns Hopkins University (US)
- Corresponding author
- Bekelman, David B.
- Venue
- Journal of General Internal Medicine
- Published
- 2009-03-14
- Volume
- 24
- Issue
- 5
- Pages
- 592-598
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC2669863
- OpenAlex
- W2064454083
- Cited by
- 306
- References
- 73
- Citations by year
- 2026: 12 · 2025: 11 · 2024: 17 · 2023: 20 · 2022: 21 · 2021: 18 · 2020: 20 · 2019: 21 · 2018: 24 · 2017: 20 · 2016: 20 · 2015: 23 · 2014: 26 · 2013: 15 · 2012: 18
- FWCI
- 12.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- Johns Hopkins University
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Keywords
- heart failure, advanced cancer, palliative care, symptom burden, depression, spiritual well-being, psychological well-being, ejection fraction, lung cancer, pancreatic cancer
- MeSH terms
- Aged, Aged, 80 and over, Cross-Sectional Studies, Depression, Female, Heart Failure, Humans, Male, Middle Aged, Neoplasms, Palliative Care, Quality of Life, Spirituality
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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