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culturally sensitive intervention, end-stage HF, palliative and end-of-life care discussion



  1. Piamjariyakul, Ubolrat PhD, RN
  2. Smith, Carol E. PhD, RN, FAAN
  3. Werkowitch, Marilyn BSN, RN
  4. Thompson, Noreen MSN, RN
  5. Fox, Maria DNP, APRN-CNS, ACHPN, CCRN
  6. Williamson, Karin Porter MD, FAAHPM
  7. Olson, Lori MD


There is an escalating prevalence of heart failure (HF) with high mortality. Compared with other races, African Americans face a higher incidence of HF at earlier age of onset, with more rapid progression, and with increased family care burden and greater care costs and disparity in health care services at the end of life (EOL). Concomitant out-of-pocket HF costs and care demands indicate the need for early discussion of palliative and EOL care needs. We therefore developed and pilot tested a culturally sensitive intervention specific to the needs of African American HF patients and their families at the EOL. Our pilot study findings encompass patient and caregiver perspectives and align with the state of EOL science. The ultimate long-term goal of this intervention strategy is to translate into practice the preferred, culturally sensitive, and most cost-efficient EOL care recommendations for HF patients and families.