Concurrent Validity and Prognostic Utility of the Needs Assessment Tool: Progressive Disease Heart Failure

People with advanced heart failure have supportive and palliative needs requiring systematic assessment. We aimed to assess the validity of the Needs Assessment Tool: Progressive Disease – Heart Failure (NAT:PD-HF). Secondary analysis of routinely collected patient data from a specialist palliative...

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Bibliographic Details
Published in:Journal of pain and symptom management 2022-05, Vol.63 (5), p.635-644.e3
Main Authors: King, Chloe, Khamis, Assem, Ross, Joy, Murtagh, Fliss E.M., Johnson, Miriam J., Ramsenthaler, Christina
Format: Article
Language:English
Subjects:
Aged, 80 and over
Cardiovascular diseases
Caregivers
construct validity
Female
Functional status
Heart failure
Heart Failure - diagnosis
Heart Failure - therapy
Hospice and Palliative Care Nursing
Humans
Information needs
Male
Medical prognosis
NAT:PD-HF
Needs analysis
Needs Assessment
Palliative Care
Patients
Prognosis
Psychological problems
Psychosocial factors
Validity
Ventricular dysfunction
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Summary:People with advanced heart failure have supportive and palliative needs requiring systematic assessment. We aimed to assess the validity of the Needs Assessment Tool: Progressive Disease – Heart Failure (NAT:PD-HF). Secondary analysis of routinely collected patient data from a specialist palliative care-heart disease service improvement project. NAT:PD-HF, the Integrated Palliative care Outcome Scale (IPOS), and patient and/or carer-report data were collected. Concurrent validity between NAT:PD-HF items and comparison measures (Kendall's tau; kappa); construct validity via known-group comparisons; predictive utility of NAT:PD-HF for survival (multivariable Cox hazard regression model). Data from 88 patients (50% men; mean age 85; median survival 205 days; 64% left ventricular systolic dysfunction) were analyzed. Prevalence- and bias-adjusted kappa values indicated moderate agreement for physical symptom needs (k: 0.33 for patients, 0.42 for carers). Substantial agreement was observed for patient and/or carer psychological symptoms, and information needs (k ≥ 0.6). NAT:PD-HF distinguished between patients with different survival, comorbidities, functional scores, and palliative Phase of Illness with moderate to high effect sizes. NAT did not predict survival when adjusted for mortality risk score and functional status (2+ needs HR: 1.52, 95% CI: 1.01-1.74). The NAT:PD-HF is a valid tool for clinician assessment of physical, psychosocial, and information patient and/or carer needs.
ISSN:0885-3924
1873-6513
DOI:10.1016/j.jpainsymman.2022.01.014