{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T09:52:53Z","timestamp":1793267573378,"version":"4.5.0"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["R01NR021630"],"award-info":[{"award-number":["R01NR021630"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Advanced heart failure (HF) often requires comprehensive home-based management, including attention to palliative care needs. Early identification of these needs can improve symptom control, safety, and quality of life for patients and families.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose is to examine end-of-life (EOL) and palliative care needs in the context of home-based HF management using systematic nursing observations and valid assessment questionnaires.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This descriptive, observational study assessed home palliative care needs among 18 patients with HF and their family caregivers enrolled in a rural Appalachian clinical trial. Data sources included questionnaires and nurses\u2019 observation notes. Home palliative care needs were assessed using: (1) the Integrated Palliative Care Outcome Scale (IPOS) to capture symptom burden; (2) EOL goals and preferences to identify care priorities; (3) a home safety checklist to evaluate environmental risks; and (4) nurse observation notes to document home visits and care challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with HF exhibited high symptom burden and home safety gaps. IPOS scores indicated persistent physical and psychosocial symptoms, with partial patient, caregiver concordance on EOL priorities but notable deficits in advance care planning. Nurse observations revealed additional HF care challenges, including medication adherence and emotional distress. Combining standardized assessments with nurse observations provided a comprehensive view of home-based palliative care needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Integrating patient and caregiver perspectives with nurse-led assessments enables proactive, home-based interventions that improve safety, symptom control, and shared decision-making. These strategies are essential for delivering patient-centered palliative care for individuals with advanced HF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091261428464","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T05:51:32Z","timestamp":1771825892000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Systematic Methods to Assess End-of-Life and Palliative Care Needs for Heart Failure Home Care"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0310-3673","authenticated-orcid":false,"given":"Ubolrat","family":"Piamjariyakul","sequence":"first","affiliation":[{"name":"West Virginia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Young","sequence":"additional","affiliation":[{"name":"West Virginia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Smothers","sequence":"additional","affiliation":[{"name":"West Virginia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann E.","family":"Hendrickson","sequence":"additional","affiliation":[{"name":"West Virginia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Asbury","sequence":"additional","affiliation":[{"name":"West Virginia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Wojciechowski","sequence":"additional","affiliation":[{"name":"West Virginia University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol E.","family":"Smith","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,22]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-022-02017-y"},{"key":"e_1_3_4_3_2","article-title":"Integration of palliative care into heart failure care: consensus-based recommendations","author":"European Society of Heart Failure Association & Heart Failure Society of America (HFSA)","year":"2024","unstructured":"European Society of Heart Failure Association & Heart Failure Society of America (HFSA). Integration of palliative care into heart failure care: consensus-based recommendations. J Card Fail. 2024. https:\/\/hfsa.org\/integration-palliative-care-heart-failure-care-consensus-based-recommendations-hfsa","journal-title":"J Card Fail"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/02692163241290350"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/diseases13120389"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11121-023-01528-y"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12061-022-09472-0"},{"key":"e_1_3_4_8_2","unstructured":"National Council on Aging. Home safety for older adults: a comprehensive guide. 2024. https:\/\/accessjca.org\/wp-content\/uploads\/home-safety-checklist-older-adults.pdf12\/1\/2025"},{"key":"e_1_3_4_9_2","unstructured":"Centers for Disease Control and Prevention (CDC). Check for safety a home fall prevention checklist for older adults. https:\/\/www.cdc.gov\/steadi\/pdf\/STEADI-Brochure-CheckForSafety-508.pdf12"},{"key":"e_1_3_4_10_2","unstructured":"American Association of Retired Persons & National Alliance for Caregiving (AARP & NAC). Caregiving in the United States 2025. 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Heart Lung. 2013;42(1):32-39. doi:10.1016\/j.hrtlng.2012.08.004.","DOI":"10.1016\/j.hrtlng.2012.08.004"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","unstructured":"Piamjariyakul U Smith CE Werkowitch M et al. Designing and testing an end-of-life discussion intervention for African American patients with heart failure and their families. J Hosp Palliat Nurs. 2016;18(6):528-535. doi:10.1097\/NJH.0000000000000290.","DOI":"10.1097\/NJH.0000000000000290"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1089\/pmr.2021.0063"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.3310\/FTRG5628"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","unstructured":"Piamjariyakul U Young S Smothers A et al. Study protocol of sustaining home palliative care for patients with Heart Failure (HF) and their family caregivers in rural Appalachia: A mixed methods randomized clinical trial. BMC Palliat Care. 2025;24(1):56. 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