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Symptom Burden, Depression, and Spiritual Well-Being: A Comparison of Heart Failure and Advanced Cancer Patients
Open accessAbstract
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. 6 , 15”
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“The symptom burden for CHF patients has been likened to those with advanced cancer or acquired immune deficiency syndrome, 6 , 12”
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“Despite optimal medical management and device therapy, patients often have persistent symptoms and long‐term reductions in quality of life (QoL)”
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Metadata
- 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
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