Background: Even though struggling with similar symptom burden, patients with chronic heart failure (CHF)\nreceive less palliative care than patients suffering from malignant diseases. Researchers have found that this might\nbe related to lack of knowledge about palliative care, insufficient interprofessional communication as well as the\ncyclic course of disease which makes accurate prognosis difficult. However, research findings have shown that\npatients with CHF benefit from palliative care. As there are no studies for the German health care system this study\naimed to assess health care professionals� attitudes regarding palliative care of CHF patients in order to identify\nbarriers and facilitators for this patient group and hence to develop recommendations for improvement of CHF\npatients� access to palliative care in Germany.\nMethod: Problem-centered interviews with 23 health care professionals involved in care of CHF patients (nurses:\nhospital, outpatient, heart failure, PC; physicians: hospital and resident cardiologists, general practitioners) were\nconducted and analysed according to Mayring�s qualitative content analysis.\nResults: Most interviewees perceived a need for palliative care for CHF patients. Regarding barriers patients�,\npublic�s, and professionals� lack of knowledge of palliative care and CHF; shortcomings in communication and\ncooperation of different professional groups; inability of cardiology to accept medical limits; difficult prognosis\nof course of disease; and patients� concerns regarding palliative care were described. Different attitudes regarding\nappropriate time of initiation of palliative care for CHF patients (late vs. early) were found. Furthermore, better\ncommunication and closer cooperation between different professional groups and medical disciplines as well as\nbetter education about palliative care and CHF for professionals, patients, and public were cited.\nConclusions: Palliative care for CHF patients is a neglected topic in both practice and research and should receive\nmore attention. Barriers to palliative care for CHF patients might be overcome by: better education for the public,\npatients, and professionals, closer cooperation between the different professional groups involved as well as\ndevelopment of a joint agreement regarding the appropriate time to administer palliative care to CHF patients.
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