ISBN: Study design and sample size Finding Quality assessment Number of studies contributing to the finding Design Criteria Rating Overall assessment of confidence pt and their carers Understanding heart failure 2b. Knowledge and management Individual interviews with pt + carers and focus groups with HCPs Individual interviews with pt + carer Open-ended narrative interviews with pt Open semi-structured interviews with pt Semi-structured interviews with pt and their carers Patients desire for more knowledge about their condition and its management is highly individual. Limitations Serious concerns about methodological limitations LOW Coherence Minor concerns about coherence Relevance No or very minor concerns about relevance Adequacy No or very minor concerns about adequacy Discussion of prognosis 3a. Difficult conversations Individual interviews with pt + carers and focus groups with HCPs Individual interviews with pt + carer and interviews or FG with HCPs Secondary analysis of interview transcripts of pt In-depth interviews with pt and following bereavement interviews with informal carers Staff reported difficulties to discuss prognosis and future care options due to the unpredictable disease trajectory, uncertainty whether patients wanted to know and difficulties handling emotional involvement of patients and their families. Limitations Serious concerns about methodological limitations MODERATE Coherence No or very minor concerns about coherence Relevance No or very minor concerns about relevance Adequacy No or very minor concerns about Referral and approach to care Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: Study design and sample size Finding Quality assessment Number of studies contributing to the finding Design Criteria Rating Overall assessment of confidence and FG with professional carers Semi-structured interviews with pt, their carers and HCPs Ethnographic study involving pt and HCPs adequacy Discussion of prognosis 3b. 