Health Needs Instrument for hospitalized single-living Taiwanese elders with heart disease: triangulation research design.
OBJECTIVE
The aims of this study were (a) to explore the health needs of hospitalized Taiwanese older people with heart disease who live alone in the community; (b) to develop an instrument to assess their health needs and (c) to examine relationships among their health needs.


METHODS
Three phases were involved in this between-method triangulation design.


METHODS
The first phase explored the contextual content of the health needs from the perspectives of a purposive sampling of 34 subjects by the use of an explorative qualitative method. The second phase developed the Health Needs Instrument (HNI) and established its reliability and validity. The last phase implemented the instrument in a cohort and examined their appraisals of each type of health need as well as the relationships among different types of health needs.


RESULTS
The HNI encompasses the following five types of health needs: help in managing tangible things, psychological support, medical support, obtaining health information and participation in decision-making. In the last phase, a purposive sample of 54 subjects (48 men and 6 women) with an average age of 75.3 years was obtained. Subjects' health needs were ranked as obtaining health information (100%), participation in decision-making (96%), managing tangible issues (87%), medical support (86%) and psychological support (67%). Detailed items for each type of health need were revealed. By examining the relationship between their health needs, the psychological needs in confronting the subjects' physical discomfort had a significant correlation with medical support (r = 0.469, P < 0.01), with tangible needs after surgery or an invasive examination (r = 0.460, P < 0.01), with informational needs (r = 0.393, P = 0.034) and with tangible needs of maintaining daily living activities during the hospitalization period (r = 0.290, P = 0.034). The need for tangible help in maintaining daily living activities during the hospitalization period was significantly correlated with the need for medical support (r = 0.341, P = 0.012), with help in managing admissions and discharge procedures (r = 0.374, P = 0.05) and with help after an invasive examination or in the postsurgery period (r = 0.334, P = 0.013).


CONCLUSIONS
Finally, a conceptual framework was developed to depict this phenomenon. With the help of this HNI, both Eastern and Western health care providers can be empowered to detect the complex health needs of this particular population earlier and more accurately in order to promote their well-being as well as their health-related quality of life.


CONCLUSIONS
Empowering nurse clinicians to assess health needs of hospitalized single-living Taiwanese elders with heart disease.
Shih
Shaw-Nin
SN
Taipei Medical University, Graduate Institute of Medical Science, College of Medicine, National YangMing University, School of Nursing [corrected] Taipei, Taiwan.
Gau
Meei-Ling
ML
Kao Lo
Chi-Hui
CH
Shih
Fu-Jin
FJ
D000368:Aged; D005260:Female; D006301:Health Services Needs and Demand; D006302:Health Services Research / Q000458:organization & administration*; D006331:Heart Diseases / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D012107:Research Design; D013624:Taiwan