Purpose: This review was performed to investigate the state of fatigue in patients with heart failure. Methods: A literature search of ICHUSHI, PubMed, PsycINFO, and CINAHL was conducted to identify articles published from database inception to March 2018. In total, one hundred and nineteen papers were included in the present review. Results: Two Japanese-language papers and one hundred and seventeen English-language papers were analyzed. None of the papers contained definitions of fatigue specific to patients with heart failure. The prevalence of fatigue was 50% to 94% according to a scale that measured not only fatigue but also quality of life. The reports indicated that severe heart failure, low exercise capacity, symptoms of depression, older age, and female sex are related to the severity of fatigue and that the severity of fatigue influences the prognosis. Conclusions: The results of our review revealed a lack of evidence for measurement of fatigue specific to patients with heart failure. Further studies are needed to establish a method by which to adequately evaluate fatigue in patients with heart failure.

Purpose: To determine how nurses perceive the need for advance care planning (ACP) for chronic heart failure with patients and their families. Methods: A questionnaire survey was administered with 427 nurses who were affiliated with implantable cardioverter-defibrillators and resynchronization therapy. The survey included 13 items related to the need for ACP for simulated advanced heart failure cases with patients and their families. Results: Valid Responses were obtained from 207 nurses. On out of all items, the least proprtion of participants (51%) responded “giving predictions about functional prognosis and life expectancy” should be performed with patients. The participants’ perceptions regarding 8 items, which included the items on communication about prognosis, reflected their belief that ACP should be performed with family members rather than the patient. It was found that participants with certification in chronic heart failure nursing were more likely to respond in favor of ACP being performed with the patients in relation to 7 items, which included “ask about what has been important in one’s life”, and being performed with the family in relation to 10 items that included “ask the family what kind of life you want the patient to have hereafter”, as compared to other nurses. Conclusion: Regarding ACP, it is suggested that nurses are careful in discussing prognosis with patients, and certified nurses tend to attach importance to the individualities and values of patients and their families.