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Unmet Needs Following Hospitalization With Heart Failure: Implications for Clinical Assessment and Program Planning

Davidson, Patricia M. PhD, MEd, BA, RN, ITC; Cockburn, Jill PhD, MSc, BSc(Hons); Newton, Phillip J. BN(Hons), RN

doi: 10.1097/01.JCN.0000338927.43469.35
Articles

Background: Measuring health status is increasingly important in both clinical practice and research. The Heart Failure Needs Assessment Questionnaire (HFNAQ) is a self-administered, disease-specific, 30-item questionnaire that measures an individual's perception of his/her needs in the physical, psychological, social, and spiritual domains.

Objectives: To assess the prevalence of needs in patients with heart failure (HF) recently discharged from hospital.

Methods: The HFNAQ was administered to participants (n = 132; mean [SD] age, 72.3 [9.69] years; 63% male) consenting to attend an HF-specific cardiac rehabilitation program.

Results: The total mean HFNAQ score was 67.3 (95% confidence interval, 65.03-69.75), indicating an average level of need around the midrange of the scale. In this vulnerable postdischarge phase, there was evidence of predominance of psychological and social concerns over physical needs. None of the variables that were examined for associations with the measures of needs reached statistical significance, highlighting the strongly individualized perception of need.

Conclusions: Higher levels of unmet needs in the psychological and social domains, compared with physical needs, identify psychosocial care as an important consideration for nursing interventions for people with HF. This study further demonstrates the importance of assessing the needs from the perspective of the individual to ascertain each person's unique perspective of the HF illness experience. Study findings further underscore the importance of individualized care planning for patients with HF after discharge from hospital to address their unique needs and circumstances.

Patricia M. Davidson, PhD, MEd, BA, RN, ITC Professor of Cardiovascular and Chronic Care, Centre for Cardiovascular and Chronic Care, School of Nursing and Midwifery, Curtin University of Technology, Chippendale, New South Wales, Australia.

Jill Cockburn, PhD, MSc, BSc(Hons) (deceased) Professor, Faculty of Health Science, School of Medical Practice and Population Health, University of Newcastle, Newcastle, New South Wales, Australia.

Phillip J. Newton, BN(Hons), RN Project Director, Centre for Cardiovascular and Chronic Care, School of Nursing and Midwifery, Curtin University of Technology, Chippendale, and Registered Nurse, Sydney West Area Health Service, Sydney, New South Wales, Australia.

Corresponding author Patricia M. Davidson, PhD, MEd, BA, RN, ITC, Centre for Cardiovascular and Chronic Care, School of Nursing and Midwifery, Curtin University Technology, Curtin House, 39 Regent St, Chippendale, New South Wales 2008, Australia (p.davidson@curtin.edu.au).

© 2008 Lippincott Williams & Wilkins, Inc.