title: Facilitating needs-based support and palliative care for people with chronic heart failure: preliminary evidence for the acceptability, inter-rater reliability, and validity of a needs assessment tool.
abstract: BACKGROUND
  Understanding the types and extent of need is critical to informing needs-based care for people with chronic heart failure (CHF).
  
  
  OBJECTIVE
  To explore the psychometric quality of a newly developed rapid screening measure to assess the supportive and palliative care needs of people with CHF.
  
  
  METHODS
  A convenience sample of multidisciplinary health professionals working in heart failure care was invited to comment, via an online survey and consultation, on suitability and required modifications to a validated cancer care needs assessment measure to inform the support and palliative care needs of patients with CHF and their caregivers. Psychometric testing was then undertaken with 52 patients with CHF recruited from a multidisciplinary heart failure service to explore inter-rater reliability and concurrent validity of the newly adapted Needs Assessment Tool: Progressive Disease-Heart Failure (NAT: PD-HF).
  
  
  RESULTS
  Health professionals (n=21) rated the tool as easy to administer, comprehensive, and relevant for the CHF population. Prevalence- and bias-adjusted kappa values indicated good agreement between pairs of raters for each item in the NAT: PD-HF (range 0.54-0.90). Participants indicating a higher severity of concern in the NAT: PD-HF physical, daily living, and spiritual items reported significantly higher Heart Failure Needs Assessment Questionnaire physical and existential scores.
  
  
  CONCLUSIONS
  This study provides preliminary evidence for the NAT: PD-HF as a potential strategy for identifying and informing the management of physical and psychosocial issues experienced by people with CHF. Further work is needed to examine additional psychometrics, benefits relating to unnecessary symptom burden, futile treatments, and admissions to hospital.
authors.affiliation: Department of Psychosocial Resources, Tom Baker Cancer Centre, Calgary, Canada. amy.waller@newcastle.edu.au
authors.forename: Amy
authors.initials: A
authors.lastname: Waller
authors.forename: Afaf
authors.initials: A
authors.lastname: Girgis
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Davidson
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Newton
authors.forename: Christophe
authors.initials: C
authors.lastname: Lecathelinais
authors.forename: Peter S
authors.initials: PS
authors.lastname: Macdonald
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Hayward
authors.forename: David C
authors.initials: DC
authors.lastname: Currow
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D002908:Chronic Disease; D019317:Evidence-Based Medicine; D005260:Female; D006333:Heart Failure / Q000451:nursing*; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data*; D015588:Observer Variation; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data*; D010166:Palliative Care / Q000145:classification / Q000706:statistics & numerical data*; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires