Facilitating Needs Based Care for People with Chronic Heart Failure: Inter-rater Reliability, Validity and Acceptability of a Needs Assessment Tool

Background: The Needs Assessment Tool: Progressive Disease – Heart Failure (NAT:PD-HF) was developed to identify and triage palliative care needs in patients with chronic heart failure. A Dutch version is currently lacking. Aims: The aim of this study was to investigate the feasibility and acceptability of a Dutch NAT:PD-HF in chronic heart failure outpatients; and to gain preliminary data regarding the effect of the NAT:PD-HF on palliative care referral, symptoms, health status, care dependency, caregiver burden and advance directives. Methods: A mixed methods study including 23 outpatients with advanced chronic heart failure and 20 family caregivers was performed. Nurses conducted patient consultations using a Dutch translation of the NAT:PD-HF and rated acceptability. Before this visit and 4 months later, symptoms, health status, performance status, care dependency, caregiver burden and recorded advance directives were assessed. A focus group with participating nurses discussed barriers and facilitators towards palliative care needs assessment. Results: Acceptability was rated as 7 (interquartile range 6–7 points) on a 10-point scale. All patients had palliative care needs. In 48% actions were taken, including two patients referred to palliative care. Symptoms, performance status, care dependency, caregiver burden and advance directives were unchanged at 4 months, while health status deteriorated in patients completing follow-up ( n=17). Barriers towards palliative care needs assessment included feeling uncomfortable to initiate discussions and concerns about the ability to address palliative care needs. Conclusions: The NAT:PD-HF identified palliative care needs in all participants, and triggered action to address these in half. However, training in palliative care communication skills as well as palliative care interventions should accompany the introduction of a palliative care needs assessment tool. Netherlands National Trial Register (NTR): 5616. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5616

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What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study

BMC Palliative Care ◽

10.1186/s12904-021-00896-y ◽

2022 ◽

Vol 21 (1) ◽

Author(s):

Stephanie M. C. Ament ◽

Lisette M. van den Broek ◽

Marieke H. J. van den Beuken-van Everdingen ◽

Josiane J. J. Boyne ◽

José M. C. Maessen ◽

...

Keyword(s):

Heart Failure ◽

Palliative Care ◽

Chronic Heart Failure ◽

Qualitative Study ◽

Needs Assessment ◽

Healthcare Professionals ◽

Assessment Tool ◽

Assessment Tools ◽

Care Needs ◽

Palliative Care Needs

Abstract Background Needs assessment tools can facilitate healthcare professionals in timely recognition of palliative care needs. Despite the increased attention for implementation of such tools, most studies provide little or no attention to the context of implementation. The aim of this study was to explore factors that contribute positively and negatively to timely screening of palliative care needs in advanced chronic heart failure. Methods Qualitative study using individual interviews and focus groups with healthcare professionals. The data were analysed using a deductive approach. The Consolidated Framework for Implementation Research was used to conceptualise the contextual factors. Results Twenty nine healthcare professionals with different backgrounds and working in heart failure care in the Southern and Eastern parts of the Netherlands participated. Several factors were perceived to play a role, such as perception and knowledge about palliative care, awareness of palliative care needs in advanced chronic heart failure, perceived difficulty when and how to start palliative care, limited acceptance to treatment boundaries in cardiology, limited communication and collaboration between healthcare professionals, and need for education and increased attention for palliative care in advanced chronic heart failure guidelines. Conclusions This study clarified critical factors targeting patients, healthcare professionals, organisations to implement a needs assessment tool for timely recognition of palliative care needs in the context of advanced chronic heart failure. A multifaceted implementation strategy is needed which has attention for education, patient empowerment, interdisciplinary collaboration, identification of local champions, chronic heart failure specific guidelines and culture.

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The Role of Electronic Medical Records (EMR) Innovations in Identifying Chronic Heart Failure (CHF) Self Care Knowledge Gaps: A Nursing Assessment Tool To Customize Patient Education at Point of Care

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2010.06.354 ◽

2010 ◽

Vol 16 (8) ◽

pp. S101

Author(s):

Ganga Hematillake ◽

Prakash Deedwania ◽

Sean McFarland ◽

Alan Cohen ◽

Jian Huang ◽

...

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Patient Education ◽

Electronic Medical Records ◽

Medical Records ◽

Assessment Tool ◽

Point Of Care ◽

Self Care ◽

Nursing Assessment

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Chronic Heart Failure Assessment Tool

PsycTESTS Dataset ◽

10.1037/t49261-000 ◽

2008 ◽

Author(s):

Karen Dunderdale ◽

David R. Thompson ◽

Stephen F. Beer ◽

Gill Furze ◽

Jeremy N. V. Miles

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Assessment Tool ◽

Failure Assessment

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Palliative care needs-assessment and measurement tools used in patients with heart failure: a systematic mixed-studies review with narrative synthesis

Heart Failure Reviews ◽

10.1007/s10741-020-10011-7 ◽

2020 ◽

Vol 26 (1) ◽

pp. 137-155

Author(s):

Bader Nael Remawi ◽

Amy Gadoud ◽

Iain Malcolm James Murphy ◽

Nancy Preston

Keyword(s):

Heart Failure ◽

Palliative Care ◽

Needs Assessment ◽

Assessment Tool ◽

Cochrane Library ◽

Patient Needs ◽

Care Needs ◽

Patients With Heart Failure ◽

Measurement Tools ◽

Palliative Care Needs

AbstractPatients with heart failure have comparable illness burden and palliative care needs to those with cancer. However, few of them are offered timely palliative care. One main barrier is the difficulty in identifying those who require palliative care. Several palliative care needs-assessment/measurement tools were used to help identify these patients and assess/measure their needs, but it is not known which one is the most appropriate for this population. This review aimed to identify the most appropriate palliative care needs-assessment/measurement tools for patients with heart failure. Cochrane Library, MEDLINE Complete, AMED, PsycINFO, CINAHL Complete, EMBASE, EThOS, websites of the identified tools, and references and citations of the included studies were searched from inception to 25 June 2020. Studies were included if they evaluated palliative care needs-assessment/measurement tools for heart failure populations in terms of development, psychometrics, or palliative care patient/needs identification. Twenty-seven papers were included regarding nineteen studies, most of which were quantitative and observational. Six tools were identified and compared according to their content and context of use, development, psychometrics, and clinical applications in identifying patients with palliative care needs. Despite limited evidence, the Needs Assessment Tool: Progressive Disease – Heart Failure (NAT:PD-HF) is the most appropriate palliative care needs-assessment tool for use in heart failure populations. It covers most of the patient needs and has the best psychometric properties and evidence of identification ability and appropriateness. Psychometric testing of the tools in patients with heart failure and evaluating the tools to identify those with palliative care needs require more investigation.

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Validation of the German version of the needs assessment tool: progressive disease-heart failure

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01817-6 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Valentina Gonzalez-Jaramillo ◽

Jelena Guyer ◽

Nora Luethi ◽

Piotr Sobanski ◽

Rut Zbinden ◽

...

Keyword(s):

Heart Failure ◽

Health Care ◽

Needs Assessment ◽

Internal Consistency ◽

Progressive Disease ◽

Assessment Tool ◽

Face Validity ◽

Health Care Personnel ◽

Retest Reliability ◽

Test Retest Reliability

Abstract Background The Needs Assessment Tool: Progressive Disease-Heart Failure (NAT: PD-HF) is a tool created to assess the needs of people living with heart failure and their informal caregivers to assist delivering care in a more comprehensive way that addresses actual needs that are unmet, and to improve quality of life. In this study, we aimed to (1) Translate the tool into German and culturally adapt it. (2) Assess internal consistency, inter-rater reliability, and test–retest reliability of the German NAT: PD-HF. (3) Evaluate whether and how patients and health care personnel understand the tool and its utility. (4) Assess the tool’s face validity, applicability, relevance, and acceptability among health care personnel. Methods Single-center validation study. The tool was translated from English into German using a forward–backward translation. To assess internal consistency, we used Cronbach´s alpha. To assess inter-rater reliability and test–retest reliability, we used Cohen´s kappa, and to assess validity we used face validity. Results The translated tool showed good internal consistency. Raters were in substantial agreement on a majority of the questions, and agreement was almost perfect for all the questions in the test–retest analysis. Face validity was rated high by health care personnel. Conclusion The German NAT: PD-HF is a reliable, valid, and internally consistent tool that is well accepted by both patients and health care personnel. However, it is important to keep in mind that effective use of the tool requires training of health care personnel.

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