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Hospice agencies serve an expanding population of patients with varying disease conditions and sociodemographic characteristics. Patients with heart failure represent a growing share of hospice deaths in the United States. However, limited research has explored the perspectives of hospice interdisciplinary team members regarding how patients with heart failure and their families navigate hospice care. We sought to address this research gap by conducting qualitative interviews with hospice interdisciplinary team members at a large, not-for-profit hospice agency in New York City (N = 32). Five overarching themes from these interviews were identified regarding components that members of the hospice interdisciplinary team perceived as helping patients with heart failure and their families navigate hospice care. These themes included (1) "looking out: caregiving support in hospice care," (2) "what it really means: patient knowledge and understanding of hospice," (3) "on board: acceptance of death and alignment with hospice goals," (4) "on the same page: communication with the hospice team," and (5) "like a good student: symptom management and risk reduction practices." Interdisciplinary team members delineated several components that influence how patients with heart failure and their families navigate hospice services and communicate with care providers. Hospice agencies should consider policies for augmenting services among patients with heart failure to improve their understanding of hospice, supplement available caregiving supports for patients without them, and remove communication barriers. [ABSTRACT FROM AUTHOR]

Introduction: Among patients with heart failure, health status is hampered by heavy symptom burden. Symptom monitoring is crucial for optimal health status, and yet patients struggle with this aspect of self-care symptom management. To help patients with heart failure report symptoms to better communicate with their healthcare providers, we developed a mHealth application, mi.Symptoms. The purpose of this study was to identify patient symptoms and predictors of health status in patients with heart failure. Methods: A patient's symptom reporting in this study was conducted using mi.Symptoms that measures acute physical symptoms with the 18-item Heart Failure Somatic Perception Scale v.3 (HFSPS) and the Patient Reported Outcomes Measurement Information system (PROMIS®) that measures non-cardiac symptoms. The primary outcome of the study was health status, measured with the 23-item Kansas City Cardiomyopathy Questionnaire Clinical Summary Score, using Qualtrics survey software. Data were analyzed using descriptive statistics, Pearson correlations, and generalized linear regression model analysis. Results: The sample (n=168) had a mean age of 58.7 (±12.54) years, 37% were female, 32% were White (n=51), 36% were Black (n=58), 44% of participants reported not having enough income to make ends meet (n=73), and the majority (48%) was symptomatic with class III HF (n=81). Overall 37% identified as Latino (n=60) and 19% completed the study in Spanish (n=33). After adjusting for demographic characteristics (age, gender, race, financial status), psychological (anxiety, depression, anger) and physical symptoms (fatigue, sleep, cognitive impairment, pain, dyspnea), the predictors of health status were NYHA Class IV (β = -11.7, p = 0.005), PROMIS physical function scores (β = 0.89, p = 0.001), dyspnea measured by the HFSPS Dyspnea subscale (β = -0.77, p < 0.001), and social limitations measured by the PROMIS social limitations score (β = 0.58, p = 0.002). Conclusions: This study demonstrates that both cardiac and non-cardiac symptoms are associated with health status. Interventions that optimize patient's physical function and social interaction with others and reduce dyspnea may improve the health status of patients with heart failure. [ABSTRACT FROM AUTHOR]