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

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.