# Prognostic communication in heart failure: protocol for a systematic qualitative synthesis of experiences, attitudes and practices

## TL;DR

This study aims to understand how prognostic conversations happen in heart failure care and what people think about them.

## Contribution

It introduces a systematic qualitative synthesis using the JBI meta-aggregation approach to explore prognostic communication in heart failure.

## Key findings

- Prognostic conversations occur infrequently or very late in heart failure disease progression.
- The study will explore how these conversations are experienced by patients and healthcare professionals.
- Findings will be synthesized to improve person-centered care practices.

## Abstract

Being able to talk about the anticipated course of living with an illness is essential to delivering and receiving person-centred care. Despite clinical heart failure guidance encouraging these prognostic conversations at all stages of disease, they occur infrequently or very late in the disease course. This qualitative synthesis will use the Joanna Briggs Institute (JBI) meta-aggregation approach to explore how prognostic conversations are currently taking place, what people think about prognostic conversations, and how people experience them.

This systematically conducted qualitative synthesis, using JBI meta-aggregation, considers qualitative evidence that explores the prognostic communication experiences, attitudes or practices of people with heart failure and their healthcare professionals. Prognostic communication is defined as a verbal interaction about anticipated changes to symptoms or function, possibility of unpredictable events, potential future treatments or care, expression of wishes about the future, or estimates of life expectancy. It will include interactions occurring in any setting (inpatient, outpatient, community). Exclusion criteria include studies of carer perspectives, discussion about implantable cardiac defibrillator deactivation, assisted dying and/or euthanasia, and those not published in the English language. Medical Literature Analysis and Retrieval System Online (MEDLINE) (Ovid), Excerpta Medica Database (EMBASE) (Ovid), PsycInfo (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus (EBSCOhost), Web of Science Core, Overton, ProQuest Dissertations and Theses Global, and Google Scholar databases will be searched for eligible studies. Reference screening of relevant systematic reviews will also be conducted. Two independent reviewers will screen, quality assess included studies and perform data extraction. JBI tools will be used for quality appraisal, data extraction, synthesis and assessing confidence of summarised findings.

Ethical approval is not required for the study since it is based on available published literature. Findings from the review will be disseminated through publication in a peer-reviewed journal.

International Prospective Register of Systematic Reviews (PROSPERO) CRD42024605240.