Cardiotoxic heart failure in breast cancer survivors: a concept analysis

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Abstract

Aim

To report an analysis of the concept of cardiotoxic heart failure in breast cancer survivors.

Background

Despite numerous studies describing cardiotoxic effects of breast cancer therapies, the literature lacks consistent terminology to describe cancer treatment-induced heart failure, defined by the authors as ‘cardiotoxic heart failure’. Breast cancer survivors who develop heart failure may not fit existing conceptual models. A concept analysis of cardiotoxic heart failure in breast cancer survivors is needed to integrate previous research findings and establish the scientific foundation for future intervention research.

Design

Concept analysis.

Data sources

An integrative review (1999–2014) was conducted to examine aetiologies and risk factors for heart failure in female breast cancer survivors. Databases searched were CINAHL, Cochrane Library, EmBase, Medline and Scopus.

Methods

Walker and Avant's method for concept analysis includes: select concept; determine purpose; identify uses; define attributes; identify model case; describe borderline, related and contrary cases; identify antecedents/consequences; define empirical referents.

Results

In the literature, substantial variation was noted in terminology for breast cancer treatment-induced cardiotoxicity. The authors define cardiotoxic heart failure in breast cancer survivors as chronic heart failure resulting from breast cancer treatment-induced cardiotoxicity among women without pre-existing heart failure diagnosis. No studies were found that described quality of life or tested interventions to preserve quality of life for this population.

Conclusion

Prospective studies are needed to develop interventions for symptom management to improve quality of life in breast cancer survivors with heart failure. New conceptual paradigms may be needed to improve outcomes for this vulnerable population.

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