Kaasalainen S, Strachan PH, Brazil K, Marshall D, Willison K, Dolovich L, et al. Managing palliative care for adults with advanced heart failure. Can J Nurs Res. 2011;43(3):38-5733
Finding 1	Challenge of managing prevailing symptoms (U)
Illustration	“I’ve had everything — you name it. I’ve had lots of angina, lots of bloating— that’s one of the reasons that I’m on dialysis … I’ve been in the hospital at least 10 times … I’ve had 3 heart attacks, I have a pacemaker, defibrillator, and now I have kidney failure. I’m a diabetic … so I’ve had every symptom you can think of … I take [nitro spray] to bed with me because during the night I get so flustered.”(p.49)
Finding 2	Hoped to be better prepared for the discussions about transitioning to palliative care (U)
Illustration	“I guess the doctors were telling me there wasn’t much they could do for me any more. I guess that’s when it really hit me that the old heart could stop any time now … when you’re feeling good and when you don’t have any pain and that kind of stuff, if they sat down and slowly brought the subject to a head. I think that would have been better than just coming right out with it, especially when you weren’t feeling well. But just the other day I was at the heart clinic and they said there were still things they could do for me.”(p.50)

U, unequivocal.