Enhancing Patient-Centered Home Palliative Care for Heart Failure: A Concept Analysis to Guide Nursing Practice and Care Coordination

Summary

This study analyzes and updates the home-based palliative care model for heart failure_, defining core components and proposing a refined_, nurse-centered framework that improves care coordination_, patient–family support_, and quality of life while guiding future research and clinical practice.

Abstract

To identify and describe components of the home-based palliative care model for patients with heart failure_, re-conceptualize the process_, and update the existing model to inform nursing research and clinical practice. Heart failure_, as a chronic progressive disease_, has a continuously increasing incidence and medical burden_, and requires multidimensional clinical management strategies. Although palliative care is recommended for improving the quality of life of heart failure patients_, its utilization rate is still low_, and the core components and implementation pathways of home-based palliative care are not yet clear. Using Rodgers' Evolutionary method_, a concept analysis was conducted to define the core components for home-based palliative care in heart failure. Data were drawn from professional literature spanning 1990 to 2025_, using the terms “home-based palliative care_,” “home palliative care_,” “home palliative treatment_,” “family hospice care_,” and “heart failure_,” “cardiac insufficiency_,” “congestive heart failure”. Abstracts from 101 articles were initially reviewed_, with 22 articles retained for analysis. Core concepts were identified_, defined_, and synthesized. The PRISMA 2020 checklist was used. The refined model clarifies nurses' roles in linking home-based palliative care core attributes: self-care_, collaborative palliative care_, communication of care goals_, and support. It presents patients'_, family caregivers'_, and healthcare workers' impact on home-based palliative care triggering_, implementation_, and outcomes_, emphasizing patient-centered continuous evaluation/adjustment. This model provides a structured framework to improve heart failure home care delivery and enhance patient/family quality of life_, with potential to inform home palliative care approaches for other chronic illnesses. Further refinement/adaptation is needed to ensure relevance across medical contexts.

Introduction

Heart failure (HF) is a chronic_, progressive condition and is the final stage of all cardiovascular diseases¹. Driven by the aging population and improved survival rates_, recent projections for the United States estimate a 46% increase in the prevalence of HF between 2012 and 2030. This rise is expected to drive healthcare costs upward by approximately 127%_, imposing a substantial economic burden on the global healthcare system². Patients with HF often suffer from a heavy symptom burden_, poor quality of life_, and repeated hospital admissions_, highlighting ....

Protocol

This research constitutes a concept analysis derived solely from existing literature and publicly accessible sources (including PubMed_, CINAHL_, Medline_, Embase_, Web of Science_, and Scopus). The study did not include the collection or analysis of individual patient data_, medical records_, CT scan data_, or any identifiable human information. Consequently_, ethical approval (IRB approval) and informed patient consent were not necessary for this study. No ethics committee review was sought_, in accordance with institutional and national research guidelines (T....

Results

Overview of the concept
The included studies were rated as moderate to high quality using the Joanna Briggs Institute (JBI) critical appraisal tools31. After initial review and chronological sorting, the articles were examined in detail to extract definitions, attributes, antecedents, consequences, settings, and contextual factors, which were recorded in Excel. Screening, quality appraisal, and data extraction were conducted by a single reviewer, with bias-control procedures described in the Protocol.......

Discussion

The early family palliative care framework was often limited in its application. When extended to HF_, models mainly focused on symptom management and were not adapted to the repeated fluctuations of the disease³. Under the existing models_, patients' autonomy is easily dominated by medical sites_, and patients are often forced to be hospitalized due to rigid treatment plans. Studies have shown that only 23% of patients with HF participate in communication about d.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
PubMed	NCBI	https://pubmed.ncbi.nlm.nih.gov/	Biomedical literature search and citation database.
CINAHL	EBSCO Information Services.	https://www.ebsco.com/?utm_source=chatgpt.com	Nursing and allied health literature database.