Associations Between Palliative Care Needs and Health Status in Heart Failure

Abstract

Introduction

Heart failure (HF) is associated with substantial functional impairment and a significant global burden, particularly in rural settings. Health status is a key patient-reported outcome, and palliative care provides supportive care that improves quality of life (QOL).

Purposes

The purposes are to assess HF-related health status as a patient-reported outcome and to examine how palliative care and psychosocial factors are jointly associated with HF health status among individuals receiving home-based care in rural Appalachia.

Methods

A cross-sectional correlational design was employed using baseline survey data from rural Appalachia. Participants were adults (≥50 years) with advanced HF (N = 79) enrolled in an ongoing clinical trial. Patient-reported HF status was assessed the Kansas City Cardiomyopathy Questionnaire (KCCQ). Also, the Integrated Palliative Outcome Scale (IPOS), psychological and sociodemographic variables were measured as independent variables. Stepwise multiple regression analyses were conducted.

Results

Participants’ mean age was 68.9 years (SD = 7.55); predominantly White (93.7%) and male (58.2%). The model showed strong results (R² = .60, P < .001), with greater palliative care needs (β = −.34) and depression (β = −.28) as the main contributors to poorer HF health status, while greater income adequacy (β = .19) was associated with better HF status.

Conclusion

The HF-related health status of individuals with HF is influenced by the complex, interrelated effects of physical symptoms, psychological distress, and social factors. Integrating palliative and psychosocial measures helps identification of unmet needs and enables more targeted, patient-centered care in rural, home-based HF populations.