The Importance of Cultural Awareness in the Management of Heart Failure: A Narrative Review

James M Beattie,1,2 Teresa Castiello,3,4 Tiny Jaarsma5,6 1School of Cardiovascular Medicine and Sciences, King’s College London, London, UK; 2Department of Palliative Care and Rehabilitation, Cicely Saunders Institute, King’s College London, London, UK; 3Department of Cardiology, Croydon University Hospital, London, UK; 4Department of Cardiovascular Imaging, King’s College London, London, UK; 5Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; 6Department of Nursing Science, Julius Center, University Medical Center Utrecht, Utrecht, the NetherlandsCorrespondence: James M Beattie, Department of Palliative Care and Rehabilitation, Cicely Saunders Institute, King’s College London, Bessemer Road, London, SE5 9PJ, UK, Tel +44 20 7848 5516, Email jmbeattie@hotmail.comAbstract: Heart failure is a commonly encountered clinical syndrome arising from a range of etiologic cardiovascular diseases and manifests in a phenotypic spectrum of varying degrees of systolic and diastolic ventricular dysfunction. Those affected by this life-limiting illness are subject to an array of burdensome symptoms, poor quality of life, prognostic uncertainty, and a relatively onerous and increasingly complex treatment regimen. This condition occurs in epidemic proportions worldwide, and given the demographic trend in societal ageing, the prevalence of heart failure is only likely to increase. The marked upturn in international migration has generated other demographic changes in recent years, and it is evident that we are living and working in ever more ethnically and culturally diverse communities. Professionals treating those with heart failure are now dealing with a much more culturally disparate clinical cohort. Given that the heart failure disease trajectory is unique to each individual, these clinicians need to ensure that their proposed treatment options and responses to the inevitable crises intrinsic to this condition are in keeping with the culturally determined values, preferences, and worldviews of these patients and their families. In this narrative review, we describe the importance of cultural awareness across a range of themes relevant to heart failure management and emphasize the centrality of cultural competence as the basis of appropriate care provision.Keywords: migration, heart failure, cultural awareness, cultural competence