April 22, 2022
Response by Nazli Parast and Jodi Heshka to OJIN topic: “Past, Present, and Future: Nurses Address the Times of Our Lives” (May 31, 2019)
I am writing in regard to the OJIN topic, Past, Present, and Future. The number of individuals diagnosed with cardiovascular disease, especially heart failure, is growing. Originally, the management of heart failure was limited, and therefore, the quality and quantity of life was also limited. Advances in medicine, including pharmacological, surgical, medical devices and lifestyle education, has led to an increase in the quality and quantity of life of individuals diagnosed with heart failure. The question arises whether the word “failure” is still appropriate, as its definition is “omission of occurrence or performance” (Merriam-Webster, n.d.). As Dr. Stevenson mentioned “words are hugely powerful. I think patients do not want to be seen as having heart failure. They don’t want to think of themselves as having heart failure. I think it can make them delay getting care, and it makes them ignore the disease” (Zoler, 2017, para 2).
It’s important to understand how patients view their diagnosis of heart failure. We believe a shift in the name of the diagnosis needs to occur. Patients enrolled in our heart failure specialized clinic, have voiced continued lack of understanding related to their diagnosis of heart failure, even after several years of being managed in a clinical setting. One patient mentioned “she did not believe it.” She had no pain and wondered how she could have heart failure if she was still alive. A second patient mentioned “heart failure” made him and his wife very depressed and experienced grief, even though he was feeling well. A third patient pointed out the negativity of the diagnosis. It “feels like there is no time left to live anymore” and does not want to talk about it or bring it up with his providers.
There are needs for additional research in this area. The way in which heart failure is perceived by providers and patients is very different, inconclusive, and leads to misunderstanding. The term “heart failure” is, for many patients, a misnomer. Perhaps a better term for “heart failure” would be “heart function”. We believe that patients’ fear of the word “failure” often prevents patients from receiving adequate education regarding their illness because failure is perceived as end point to a condition. These are major barriers to medical optimization and overall patient well-being. Therefore, let’s focus on the bigger picture of reducing ambiguity when diagnosing a health condition.
Nazli Parast, EdD(c), MN, BScN, RN, CDE
Jodi Heshka, MD, MSc, FRCPC
Ottawa Cardiovascular Centre, Ottawa, Ontario
Merriam-Webster. (n.d.). Failure. Merriam-Webster.com Dictionary. https://www.merriam-webster.com/dictionary/failure
Zoler, M. L. (2017, June 5). A prescription for heart failure success: Change the name. Conference Coverage. https://www.mdedge.com/chestphysician/article/139783/heart-failure/prescription-heart-failure-success-change-name